DRUG ADDICTION AND ABUSE AMONG MILITARY VETERANS, 1971 TUESDAY, JUNE 15, 1971 U. S. SENATE, SUBCOMMITTEE ON HEALTH AND HOSPITALS OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D.C. The joint subcommittees met, pursuant to notice, at 9:30 a.m., in room G-308, New Senate Office Building, Senator Alan Cranston (chairman, Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs) presiding. Present: Senators Cranston, Hughes, Schweiker, and Stevens. Committee staff members present: Jonathan R. Steinberg, counsel, and Wade Clark, counsel, Committee on Labor and Public Welfare; F. Keith Leach, professional staff member, and Guy H. McMichael, professional staff member, Committee on Veterans' Affairs. Senator CRANSTON: The hearing will please come to order. This is the first joint session of the Health and Hospitals Subcommittee of the Veterans' Affairs Committee and the Subcommittee on Alcoholism and Narcotics of the Labor and Public Welfare Committee. Senator Harold Hughes, who is chairman of the Subcommittee on Alcoholism and Narcotics of the Senate Labor and Public Welfare Committee and a member of the Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs will open today's session with an opening statement. Senator HUGHES. The Subcommittee on Alcoholism and Narcotics of the Committee on Labor and Public Welfare is privileged to join with the Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs at these hearings today. Our subject is one of extreme national importance, and one that grows more urgent with the homecoming of each returnee from the Vietnam morass: drug abuse and drug addiction among veterans and among those who will soon join their ranks. Since World War II particularly, a grateful nation has generously rewarded the men and women who have fought its wars. It has been especially concerned for those who have been physically maimed. But today we are confronted by a new kind of war casualty: the drug addict. (3) He may have been hooked before he entered service; as our subcommittee has consistently pointed out, the military's induction centers have been notorious sieves for the individual already addicted or disposed to become addicted. Or, as is becoming more and more the case, he may have acquired his drug habit in service. Boredom, lack of job satisfaction, a social milieu that leaves the GI without any control over an improvement in his environment-these and many other factors have undoubtedly influenced many men to sniff or to inject the heroin they find so readily available, whether in Southeast Asia, at military bases in this country, or in Europe. In the main, the military services have reacted by dumping most servicemen with drug problems untreated and unrehabilitated back into a civilian society poorly prepared for them. As was brought out at our subcommittee hearings last week, more than 16,000 servicemen have been punitively or administratively discharged for drug abuse during the past 2 calendar years. Of these, almost 11,000 received a type of discharge undesirable, bad conduct or dishonorable--that rendered them ineligible for treatment in a Veterans' Administration facility. We do not know how many of these 16,000 may have been hardcore drug addicts. We do know that for most of those who are hooked, there is only one way to support their deadly habit here in the United States and that is by criminal acts. Of the Government's new estimate of 250,000 heroin addicts in this country, it is generally agreed that a substantial part of them are veterans. It is likely that most of these received types of discharges that disqualify them from treatment in a VA hospital. But if only a small percentage of these were eligible for VA treatment, the record is plain that if they had sought help, all but a handful would have been turned away for lack of adequate facilities. Senator Cranston, in his statement, outlines the facilities presently in existence and the plans the VA has for coping with the epidemic. Even given the most rapid escalation conceivable of these plans, I question whether they represent a realistic blueprint for dealing with a need of this magnitude. We had hoped to explore these pressing issues with representatives of the VA at hearings tomorrow. But I regret to report that they have declined to be here. Some weeks ago, the Administrator of the Veterans' Administration, Mr. Donald E. Johnson, made known his desire to testify on the subject of drug abuse whenever hearings were scheduled. Accordingly, when these hearings were being arranged, Mr. Johnson was apprised and the second day's hearings were scheduled for 2 p.m. tomorrow, June 16, in order to accommodate the Administrator's own schedule. Later, however, staff members were advised that Mr. Johnson had found it physically impossible to testify at the agreed time, although no reason was given. He suggested that his appearance be postponed until June 22 or 23. We had also planned to have on hand tomorrow a representative of the Department of Health, Education, and Welfare, which has responsibility for treatment facilities elsewhere in the civilian community. But HEW also declined to testify at these hearings. In view of the refusal of the VA Administrator to appear as he originally agreed to do, tomorrow, and the refusal of HEW officials to testify at that time we are canceling the hearing scheduled for tomorrow, by agreement with Senator Cranston, and will look forward to hearing from Mr. Johnson and from a representative of HEW on June 23. I must say that I am deeply disturbed by this lack of cooperation. We are dealing with a matter of the utmost urgency in which a massive volume of facts needs to be examined in depth. A few weeks time can make a tragic difference in the growth of the problem. Last week the Department of Defense, acknowledging the urgency, agreed to testify at both sets of hearings although they had originally asked also for postponement until the 22d. I believe it is now apparent that there was ample material to be presented at last week's hearings before going into the administration's new plans for dealing with the drug abuse problem which, I understand, will be ready for presentation next week. I underscore this matter of cooperation between the executive and the Congress and all agencies involved because, realistically, if we are to get the drug abuse plague controlled in the United States-in both military and civilian sectors-it will require a total effort of all parties working closely together. I would like to express the regrets of Senator Packwood for his inability to be here today. As usual we have two or three other committee conflicts and some of the members are unable to join us. Thank you very kindly, Mr. Chairman. Senator CRANSTON. Thank you very much, Senator Hughes, for being with us. It is a particular pleasure and honor for me to join my very good friend Senator Harold Hughes in these vitally important hearings into how our Nation should respond to the epidemic of drug addiction among our returning veterans. I have worked closely with Senator Hughes on both veterans' matters and alcoholism and narcotics matters since we both entered the Senate in January 1969. And I am delighted to be continuing this work with him this Congress on the Labor and Public Welfare and Veterans' Affairs Committees. More than any other American, Harold Hughes has stirred our national conscience about the scourge of drug abuse and drug addiction which sweeps our country like an infectious disease and now threatens far greater destruction of the lives and welfare of our servicemen, veterans, and their families than the war in Southeast Asia itself. This morning I would like to express my regret that Senator Vance Hartke who wishes to be with us, cannot be with us, and also that Senator Strom Thurmond, the ranking Republican, cannot be with us. Both are deeply interested in the problem we are discussing, but have scheduling conflicts preventing their attendance at this hearing, as with the other members of the subcommittee. Senator Hughes in his opening statement has outlined some findings from his subcommittee's recent hearings into drug abuse and drug addiction in the miltiary. Listening to him describe this new kind of escalation in Vietnam makes abundantly clear why we are holding joint hearings this morning. The problem before us cannot be approached as either solely a military problem or as solely a veterans' problem. Rather, just as Senator Hughes and I have brought our two subcommittees together to explore the problem at these hearings-and, indeed, as Senator Stennis, chairman of the Senate Armed Services Committee, has been so totally cooperative with Senator Hughesboth the Veterans' Administration and the Department of Defense must totally integrate and coordinate their programs of drug prevention, treatment, rehabilitation and followup if the Nation is to respond adequately to this tragic challenge. And these two agencies must be joined in the civilian sector by community programs throughout the country, with responsibility at the Federal level residing in the Department of Health, Education, and Welfare. Senator Hughes has described the veteran addict population as totaling 80,000 to 90,000 during the coming fiscal year 1972. As he has indicated, most of the afflicted veterans have returned to this country over the last several years and have received no care or attention from the Veterans' Administration. So this is really not a new problem we focus on today. Yet the Government's response so far has been to open five Veterans' Administration drug dependence units around the country. And these were opened only in 1971. Given the devastating extent of the drug addiction problem among veterans, it is shocking to me that right now the VA is treating only 219 in-and-out patients for drug addiction at these five centers, with 116 veterans now on the waiting lists at these new facilities alone. In the face of this, the Veterans' Administration planned in its fiscal year 1972 budget to open up 13 new centers by June 30, 1972, for a total of 18 centers. These 18 new units originally slated for next fiscal year are funded in the budget with only $3.2 million additional. This is only about $175,000 per unit. Actual experience with the five units already indicates this figure is far too low. Units operated for a full fiscal year require about $540,000 in the first year and $480,000 thereafter with about 35 staff members for each unit's in-and-outpatient programs. By contrast, the VA's plans, after meat-taxing by the Office of Management and Budget, allow for less than half the necessary funds and one-third the necessary staff in order to run an effective drug abuse treatment program with adequate followup and the requisite individual care. For fiscal year 1973 the VA initially projected opening 12 more of these drug dependence units for a total of 30 in operation by June 30, 1973. But, as the Hughes subcommittee turned up the heat on the military drug abuse problem, some of the flames apparently began igniting these VA plans. Now, VA representatives say they will accelerate their plans and make all of these 30 centers operational by the end of fiscal year 1972. They also seem to be talking about opening an additional 30 centers by mid-1973. I understand that each of these projected centers is to be capable of treating 200 addicts annually for a total agencywide capacity during the next fiscal year of 6,000 veteran addicts, less than 7 percent of the estimated total number of veteran addicts requiring treatment and rehabilitation. The Veterans' Administration, the Congress, and all of us in the country can and must do better than that. As I believe these hearings will demonstrate, we cannot rely on community facilities in the private sector to take up this enormous slack. These local facilities are already severely overburdened and are far too few with far too little funding support from the Federal Government, or local or State governments for that matter. These hearings are intended to reveal to those of us on these two subcommittees and to the American public exactly what resources can be effectively utilized in the next fiscal year in order to make the maximum possible attack on this problem. At a minimum, it seems to me that we must double the new VA estimate and have 60 units operational by this time next year, with a capacity to treat 12,000 addicted veterans annually. To do this job properly will require a minimum of $28 million more than is budgeted. And then untold millions will still be needed. I pledge myself-together with Senator Hughes and my good friend "Tiger" Teague, chairman of the House Veterans' Affairs Committeeto do all we can to convince the Appropriations Committees in each House and the full Congress that all necessary funds must be made available immediately for these programs. Also these hearings are designed to find out what changes in the law are needed to open up treatment and rehabilitation to every veteran addict. As Senator Hughes indicated in his statement, there may already be as many as 11,000 addicted veterans with bad conduct or dishonorable discharges which prevent them from receiving treatment from a VA facility. We must decide how most appropriately to change the law in order to render these men eligible for full treatment and rehabilitation. This can be done either by amending the laws so that addiction is treated as service-connected or by authorizing full treatment and rehabilitation regardless of the question of service-connection or the type of discharge. But, however we choose to establish eligibility, we must provide that all drug addicted veterans be offered a comprehensive treatment and rehabilitation program including the fullest outpatient treatment and followup and complete vocational rehabilitation, education, and job counseling of the type presently available to certain disabled vet |