98 15 to 20 beds. You add this up. We are talking about 200, and mayb 97 beds. This is grossly inadequate. You can't do anything for thi number of veterans in 297 beds. I wouldn't think so. We have to get on a crash program. Whether or not we have th availability of medical personnel that know enough about drugs is real problem. If you will recall, a year ago they were trying to tel us if we gave the VA an extra $155 million, some of the VA hos pitals didn't need it and couldn't spend it. I was told by a high officia. in the VA Department of Medicine and Surgery for the first time they have 6,000 applications from doctors now wanting to work for the Veterans' Administration. So I think if all of us want to stop this jawboning and get to work and set aside beds for drug addicts and really get realistic, I believe the young veteran will finally believe us and report in for treatment and he will drop the habit. At least we are hoping so. Senator HUGHES. I would like to ask you a series of questions. I think you have already answered most of them in your statement, so I will not have to ask too many of them. I want to compliment you on what I think is a tremendously progressive attitude. With the repeated attitudes of these veterans' organizations and the leadership of an organization such as yours, with a heavy membership in the Orient, I believe we can draw attention by the Government to make these resources available. Mr. STOVER. We have these resources. We have a rehabilitation service. We represent these men free of charge. When the Vietnam Veterans Against the War were in Washington, we had five men who came to ask us to represent them for arrest for smoking marihuana. So maybe through these young men that we are going to try to represent, the public will learn about this. Senator HUGHES. I wish you every success. Do you favor giving full treatment to military veterans, even though dishonorably discharged? Mr. STOVER. Yes. If they are a veteran. The VA should take care of them-rehabilitate them. These veterans are not heroes. But nevertheless veterans who desperately need help. The VA takes care of the aftermath of war and these drug addicted veterans are a part of the war's consequences. Senator HUGHES. Should they receive full care when they come back? Mr. STOVER. Yes. We believe the full resources of the VA should be given to solve this problem, whether medical or otherwise. It seems ridiculous to limit the Veterans' Administration capability to these drug centers. We think they should use every available resource and service to solve this problem. Senator HUGHES. Do you favor involuntary treatment in the VA hospitals beyond the serviceman's regular tour of duty? Mr. STOVER. Yes; we do. We favor transferring him to the VA, if necessary. There is a precedent for this. In World War II we had a large number of neuropsychiatric cases which were committed involuntarily to VA hospitals where, I am sorry to say, some of them may even still be. So there is a precedent for that, Mr. Chairman. When it is for the benefit and good of the veteran, which I think it would be regarding drug care in this instance then we are for it. Senator HUGHES. Do you favor amending the law so that detoxified veterans are eligible for benefits of chapter 31, the Vocational Rehabilitation Program, so long as they remain clean? Mr. STOVER. Vocational rehabilitation requires that the veteran be declared service connected. Then you are talking about a veteran drawing disability compensation, usually 30 percent or more. Then you are talking about a veteran who has a vocational handicap because of an injury or disability incurred in his tour of duty. That is another thing. The problem the VA will have when they have been detoxified is getting them a job. I think we ought to clear away all the cobwebs and obstacles. So the VA, can utilize all of its services including psycological and vocational counseling. But vocational rehabilitation is a different ball game. Senator HUGHES. Part of the greatest problem we have is that many of these men have to develop a completely new lifestyle, an identity with the structure, and everything else, and this is what primarily we are referring to in this. Mr. HOLT. The thing that bothered me this morning was, of course, the eight young men were impressive, they are always impressive, but half of them, at least I gathered half of them, had never actually been in what we call combat, carried the rifle out there and faced the enemy. They were in hospitals and headquarters companies, or something like that. Certainly we, in the Veterans of Foreign Wars, want to tip our hat on every occasion we get, to that 90 percent of the young men who did not decide to go the drug route that these drug addicts took. The hard thing to do is stay off drugs, and all of the men who came back clean should be commended not only for serving their country well, but for not partaking in the drug addict program. Senator HUGHES. The point is very clearly taken. Can we have the compassion in spite of the breakdown? Mr. HOLT. As you indicated, they do have the compassion of the American people at the moment. Senator HUGHES I might ask you a question because of your familiarity with the structure of VA and its funding. Do you favor specifically earmarking additional funds for drug treatment in the VA appropriation bill so as to prevent absorption of medical care of VA appropriations? Mr. HOLT. That is the way it would have to be, by all means. Senator HUGHES. We are going to have trouble with feed-off from other programs. Mr. STOVER. As you know, the present 1972 VA hospital budget anticipates and is predicted on a reduction of 6,000 average daily patients a day in VA hospitals. So we are hopeful that Congress will reject this, but this is the budgetary mood that we find the administration in. They are trying to save money at the expense of veterans in this manner. There is about $120 million that would be saved if about 5,000 or 6,000 patients a day were reduced. I think to go along with your line 100 of reasoning, if additional funds are earmarked for meeting this prob lem, separately identified drug funds would have a better chance o being approved by the Congress. There would be less working around behind the scenes, killing off the appropriation or taking some other crippling type of action while the legislation is going through the Congress. Mr. HOLT. I think it so happens, Senator, I believe this has to be a 10- or 20-year program. Again, if we move now, we think in a 2-year period we could have this problem whipped. At least we won't have 60,000 drug addicts running around the streets. Senator HUGHES. History seems to indicate this runs in cycles in the military. Apparently we are hitting the peak of the cycle now. Certainly there is no longer any question as to the fact that we are leaving Vietnam. It is a question of how rapidly we leave, which will certainly reduce the exposure to what is the greatest source of addiction in the military. I think realistically, if we kid ourselves into believing this is only going to be 2-year program, we are wrong, because we have so many veterans at home, plus the fact we have a quarter of a million men in Vietnam, plus a broad dispersement around the world with other men. The problems, however, are not so heavy in other sections. Mr. STOVER. That is very true, but the situation is, even though with a small number of beds that VA has in operation now, the men are not reporting in in any great number. This is something we have to work on. Senator HUGHES. I think I can understand why they are not, and you can, too. I think if we change a couple of things, they will be reporting in, but it will have to be changed. I think that can rapidly happen. Gentlemen, I want to thank you very much, particularly for your patience, and also for your expertise. I think you identify with this problem very clearly. You made some sound recommendations and your testimony is very helpful to this committee. The hearings of the subcommittee are recessed until 9 a.m., Wesdnesday, June 23, when we will hear from the Administrator of Veterans' Affairs, Donald E. Johnson and other Veterans' Administration witnesses. We are also inviting to these hearings the Secretary of Health, Education, and Welfare, Richardson, and New York Police Commissioner, Murphy, in order to give the broadest possible focus to this problem, including the role of civilian treatment facilities, crime prevention, and current implications of drug addiction among veterans. The hearing is recessed. (Whereupon, at 3:10 p.m. the subcommittee recessed, to reconvene at 9 a.m., Wednesday, June 23, 1971.) DRUG ADDICTION AND ABUSE AMONG MILITARY VETERANS, 1971 WEDNESDAY, JUNE 23, 1971 U.S. SENATE, SUBCOMMITTEE ON HEALTH AND HOSPITALS OF THE Washington, D.C. The subcommittees met at 9 a.m., pursuant to recess, in room G-308, New Senate Office Building, Senator Alan Cranston, chairman of the Subcommittee on Health and Hospitals of the Committee on Veterans Affairs and Senator Harold E. Hughes, chairman of the Subcommittee on Alcoholism and Narcotics of the Committee on Labor and Public Welfare, presiding. Present: Senators Cranston, Hughes, Hartke, and Hansen. Staff members present: Wade Clark, counsel; and Jonathan R. Steinberg, counsel, of the Committee on Labor and Public Welfare; and F. Keith Leach, professional staff member; and Guy H. McMichael III, professional staff member, of the Committee on Veterans' Affairs. Senator CRANSTON. The joint committees will come to order. Senator Hughes, are you all ready? This morning, we are continuing our joint inquiry into the problem of veterans drug addiction and will hear testimony from the administration, the American Civil Liberties Union, the Addiction Services Agency of the city of New York, and representatives of veterans organizations. Last Tuesday, June 15, the joint subcommittees received some extremely interesting testimony from a panel of Vietnam and Korean conflict former addicts, the directors of a community-based drug treatment program in Sacramento, Calif.; from eminent psychiatrists; and representatives of veterans organizations. There was general agreement that the Veterans' Administration drug treatment program requires very substantial expansion; that the VA needs authority to treat all addicted veterans, regardless of the nature of their discharges or findings of service-connection for their addiction; that comprehensive services should be provided with particular emphasis on vocational and educational training; and that major reliance should be placed on relationships with local treatment facilities, especially communitybased programs, rather than the VA attempting to do the enormous job itself with VA facilities. (101) On Monday, June 21, I introduced S. 2108, the proposed "Veterans Drug and Alcohol Treatment and Rehabilitation Act of 1971," in order to carry out most of these areas of agreement. The principal focus of the measure is to provide the most comprehensive treatment and rehabilitation for all addicted veterans regardless of the nature of their discharges or findings of service-connection for their addiction. Right now, under present VA law and regulation, a veteran who received an honorable discharge but was "hooked" during service, without actual or official notice being taken of his addiction, can qualify for care, but a veteran who made a mistake and is discovered, received, until very recently with the inception of limited amnesty programs, a less than honorable discharge and has usually, thereby, been made ineligible for treatment. This disparity of treatment makes no sense whatsoever. The bill also covers treatment and rehabilitation for alcoholism and alcohol abuse, as well as treatment and rehabilitation for drug addiction and abuse, for a number of reasons. First, alcohol abuse, although far less publicized than drug abuse, is a significant problem for returning servicemen. Second, alcoholism continues to be the most prevalent, largely untreated disease in this country. According to Senator Hughes' estimates, alcoholism afflicts some 9 to 12 million Americans, touches the lives of about four times that number through family relationships, and is responsible for more than 25,000 highway deaths a year. Third, alcoholism has always been a special responsibility of the Veterans' Administration. About one in eight of current VA hospital patients suffer from alcohol-related disabilities, and alcohol-related disorders treated in VA hospitals doubled between 1965 and 1969. One of the major features of the bill is that the present comprehensive vocational rehabilitation program for disabled veterans, under chapter 31 of title 38 of the United States Code, is made an integral part of the addict's treatment and rehabilitation. All compétent authorities agree that successful addict rehabilitation programs must include a full program of vocational and educational counseling, training and education, job or education placement, and some provision for the addict's subsistence while undergoing treatment and rehabilitation. All this would be carried out as part of the vocational rehabilitation program for drug and alcohol addicts. If the veteran dropped out of the rehabilitation program or returned to drugs after discharge from the program, he would lose his eligibility for chapter 31 vocational rehabilitation benefits. As a corollary of this provision, the bill also provides that a veteran with less than an honorable discharge who is discharged from a rehabilitation program as recovered and who continues to be "clean" of drugs or alcohol abuse for a year thereafter will be deemed, as a matter of law, to have been honorably discharged from the service for the purpose of eligibility for all VA benefits. In terms of the type of treatment, S. 2108 emphasizes a comprehensive program offering multiple-treatment modalities and authorizes the VA to contract with community-based programs to provide treatment and rehabilitation. The bill stresses using former addict counselors and authorizes the administrator, in his own programs, without regard to the civil service classification laws or regulations, |