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vention efforts and the appropriateness of allocating the majority of scarce prevention funds to DOE.
10. The committee has found that the most successful prevention programs are community-based as opposed to schoolbased. In particular, viable prevention programming that targets poor, urban and minority communities is also communitybased. Such community-based programs are primarily funded through ADAMHA. Therefore, the committee recommends that ONDCP prioritize community-based prevention efforts and increase significantly ADAMHA's budget to enable them to expand their prevention programming.
The committee held four hearings which examined prevention programming efforts, including a national overview of prevention strategies and three field hearings in large urban cities-Detroit, Los Angeles and Chicago. Common issues emerged from these field hearings including: the lack of funding to conduct ongoing prevention programming; insufficient prevention research conducted on communities of color which would facilitate community understanding on what efforts have failed and on those that work; inadequate access to resources including training, staff development, organizational development, community outreach and grant information; and the need for more active federal leadership in coordinating prevention efforts at all levels of government.
The following hearings pertaining to substance abuse prevention efforts were held by the Committee on Government Operations. With the exception of the December 14, 1989 joint hearing with the Subcommittee on Government Information, Justice and Agriculture, all other hearings were held exclusively by the Subcommittee on Legislation and National Security.
1. The Impact of the President's National Drug Strategy on Michigan, December 14, 1989.-Chairman John Conyers, Jr. and Subcommittee Chairman Robert E. Wise, Jr. presided over the oversight hearing held in Detroit, Michigan. Witnesses were: Eural Alexander, Community Relations Representative, Insight Recovery Center; Founder, Director, Concerned Addicts Reaching Inward To Everybody (CARE); Jennetta Moffitt, Community Representative, CARE; Michael Knox, Community Representative, CARE; The Honorable Maryann Mahaffey, President-Elect, City Council of Detroit; The Honorable Alberta Tinsely-Williams, Commissioner, Wayne County; Warren Gregory, Associate Director, House Fiscal Agency, Lansing, Michigan; The Honorable Francis Pitts, Judge, Juvenile Division Wayne County Probate Court, Detroit, Michigan, and President, Black Judges of Michigan; Donald L. Reisig, Director, Office of Drug Agencies, Detroit, Michigan; Barbara Hower, Health Education Consultant for the Comprehensive SchoolHealth Unit, Department of Education, Lansing, Michigan; Lisa Daily, Administrator, Office of Substance Abuse Services, Lansing, Michigan; The Honorable Dalton A. Roberson, Chief Judge, Recorders Court, Detroit, Michigan; Patricia A. Cuza, Director, Office of Criminal Justice Services, Lansing, Michigan; Stephen J. Markman, U.S. Attorney, Eastern District, Detroit, Michigan; James Neuhard, Director, State Appellate Defender Officer, Detroit, Michigan; William Coonce, Special Agent, Drug Enforcement Administration, Detroit, Michigan; Major Michael Robinson, Department of State Police, East Lansing, Michigan; Rudolpho Thomas, Commanding Officer, Narcotics Division, Detroit Police Department; Dr. Verona Morton, Group Consultant, Private Health Systems, Inc.; Earl Henderson, Sergeant-at-Arms, Save Our Sons And Daughters, Detroit, Michigan; Laura Hess, Health Care Specialist, International Union UAW Social Security Department; David Fukuzawa, Director of Health and Substance Abuse, New Detroit, Detroit, Michigan; Lawrence Marantette, President, A&R Development Corporation and Chair, Public Safety Committee, Board of Directors, Detroit Chamber of Commerce; Robert Koval, Director, Sacred Heart Rehabilitation Center accompanied by Dr. Gregory Berger, Sacred Heart Rehabilitation Center; William Peabody, Clinical Director, St. John Macomb Hospital, Oxford Center, on behalf of the Michigan Coalition on Substance Abuse, Detroit, Michigan; George Gaines, Director, Public Health Department, Detroit, Michigan; Dr. James Sall, Director, Bureau of Substance Abuse, Department of Health, Detroit, Michigan; Dr. Richard Levinson, Director, Detroit Department of Health, Detroit, Michigan; Reverend John Marks, Executive Director, Baptist Programs Council, Detroit, Michigan; Modesta N. Fields, Michigan Chapter, National Black Alcoholism Council; and, Jacqueline Morrison, Vice President of Programs, Urban League, Detroit, Michigan.
2. Oversight hearing on drug abuse prevention and education, April 3, 1990.-Chairman John Conyers, Jr. presided at this Washington, D.C. hearing, and the witnesses were: Dr. Elaine Johnson, Director, Office of Substance Abuse Prevention, U.S. Department of Health and Human Services, Rockville, Maryland; Dr. Allan Y. Cohen, President, Pacific Institute for Research and Evaluation, Washington, D.C. and Berkeley, California; Reggie Williams, Former Linebacker, Cincinnati Bengals, Cincinnati, Ohio; Professor Gail G. Milgram, Director, Education and Training Division, Center of Alcohol Studies, Rutgers University, Piscataway, New Jersey; Roy Allen, Jr., Director, Department of Health and Physical Education of the Detroit Public Schools, Detroit, Michigan; Andrea Schneider, Director, Drug Abuse Prevention Services, Santa Clara County, California; Eldrin Bell, Deputy Chief, Field Operations, Atlanta Police Department, Atlanta, Georgia; Mahmoud T. Baptiste, Project Director, TEAM accompanied by Shanta Calloway and Genevieve Baptiste, students; Charlene Doria Ortiz, Associate Director, Center for Health Policy Development, Inc., San Antonio, Texas accompanied by Larry Gasco, Health Staff Analyst, County of Los Angeles, AIDS Program Office Los Angeles, California; and, BoisSan Moore, Assistant Director, Institute on Black Chemical Abuse, Minneapolis, Minnesota.
3. The Impact of the National Drug Control Strategy on California, July 2, 1990. Chairman John Conyers, Jr. presided over this hearing and was accompanied by Representatives Barbara Boxer and Julian Dixon. Witnesses were: The Honorable Thomas Bradley, Mayor, City of Los Angeles, California; Chauncy Veatch, Director, Governor's Policy Council on Drug and Alcohol Abuse, Sacramento, California; Lisa Lee, Resident, Tarzana Treatment Center accompa
nied by Scott Taylor, Director, Tarzana Treatment Center, Richard E. Browne, Chief, Contract Management/Program Budget and Patrick Ogawa, Chief, Planning, Program, Development and Technical Assistance, Drug Abuse Program Office Los Angeles County Department of Health Services, Los Angeles, California; Thelma Brown, Representative, Watts Health Foundation, Inc., Los Ange les, California; Patricia Herrera Duran, Executive Director, Joint Efforts, San Pedro, California; Michael Watanabe, Director, AsianAmerican Drug Abuse Program, Los Angeles, California; Dr. Ruth Rich, Director, Drug Free Schools and Communities, Los Angeles Unified School District, Los Angeles, California; Dr. Mark Ridley. Thomas, Executive Director, Southern Christian Leadership Conference, Los Angeles, California; Steve D. Valdivia, Executive Director, Community Youth Gang Services, Los Angeles, California; Dr. Benjamin P. Bowser, Director, Multicultural Inquiry and Research on AIDS, Bayview Hunter's Point Foundation, San Francisco, California; David L. Winett, Assistant Director, State of California, Department of Corrections, Office of Substance Abuse Programs, Sacramento, California; Dr. John Irwin, Senior Fellow, National Council on Crime and Delinquency, San Francisco, California; Commander Robert C. Ripley, Detective Division II, Los Angeles County Sheriff's Department, accompanied by Operations Lieutenant Gerald Barnes, Narcotics Bureau, Los Angeles County Sheriff's Department, Los Angeles, California; and, David Meyer, Assistant Director, Public Defenders Office, Van Nuys, California.
4. The Impact of the National Drug Control Strategy on Illinois, July 28, 1990.-Chairman John Conyers, Jr. presided over this hearing held in Chicago, Illinois and was accompanied by Representatives Cardiss Collins and Charles A. Hayes. The witnesses were: The Honorable Richard M. Daley, Mayor, City of Chicago; Father Michael Pfleger, Pastor, St. Sabina Church, Chicago, Illinois; The Honorable Margaret Smith, Senator, State of Illinois; The Honorable Timothy Evans, Alderman, City of Chicago; The Honorable Cecil A. Partee, States Attorney, Cook County, Chicago, Illinois; Elijah Cook, Chief of Police, Chicago, Illinois; William T. Atkins, Director, Illinois Department of Alcoholism and Substance Abuse, Chicago, Illinois; Dr. Edward C. Senay, Research Director, Addiction Research Institute of the State of Illinois, Chicago, Illinois; Eldoris Mason, Executive Director, The Brass Foundation, Chicago, Illinois; Claude Rhodes, Community Outreach Worker, Chicago, Illinois; Michael J. Darcy, President and Chief Executive Officer, Gateway Foundation, Chicago, Illinois; Larry Smith and Alex, clients, Gateway Foundation; Rick Velasquez, Clinical Director, Youth Outreach Services; and, Paul Kelly, Director, Bobby Wright Comprehensive Community Mental Health Center, Chica
C. DISCUSSION The Subcommittee on Legislation and National Security examined the salient issues of the National Drug Control Strategy through hearings, interviews and investigation in an effort to assess the strengths and weaknesses of federal policy, and to recommend appropriate action necessary to respond to the scourge of
substance abuse which is taking its toll on families, in the work place, and in the community.
In this report we examine the Federal Government's prevention efforts as they relate to the communities across the United States. The committee's analysis of this aspect of the federal strategy reveals both a sense of hope and despair at the community level where results are promising, but resources are scarce and national leadership is negligible.
Prevention programming is an emerging discipline that is still suffering growing pains, but has yielded some promising results. Practitioners in the field and in academia have come to some consensus on this complex, multifaceted field, yet are receiving little encouragement from policy makers in Washington. ONDCP Director William Bennett has often asserted the necessity of prevention as part of a larger strategy to combat substance abuse, yet at the same time stated that the Federal Government should not put money into such programs until their effectiveness is proven. As a result, prevention strategies overall are receiving only $1.1 billion, or less than $5 per person in the United States. A similar litmus test has never been applied to AIDS or cancer prevention programming, nor have there been any rigorous longitudinal evaluations of their impact. Yet substance abuse prevention programming has been held hostage until clear statistical proof of the effectiveness can be generated.
There is evidence suggesting approaches that are working and those that are unlikely to be effective. Strong national leadership to set high standards of accountability and evaluation of programs funded at the federal and state levels could easily be implemented while long-term prevention research is allowed to progress and subsequently prove program effectiveness.
Fiscal motivation alone should favor investment in prevention programming to save human dollar costs incurred by the use of drugs-eventual treatment, prosecution and incarceration. Tangible results showing that prevention works can be measured by the National Household Survey and the Annual High School Senior Survey, statistics on primarily the educated and the middle class. We know that millions of people have been deterred from trying drugs through primary prevention and education, and millions of others have stopped experimenting with drugs before dependency.8 Casual use of cocaine in particular has decreased significantly. There is a:
correlation between the use of cocaine and marijuana by
Statement by Allan Y. Cohen before the Subcommittee on Legislation and National Security, April 3, 1990, p. 7.
note that efforts to educate our young people as to the
dangers of drug use seem to be taking hold. While welcome news, there is a significant portion of the American population which has not been reached by such prevention efforts. This is indicated by the fact that the rate of addiction has not decreased. The use of drugs, especially crack, in our inner cities has increased. Similarly, substance abuse in communities of color across the United States has not abated. 10 The committee is concerned about the seeming lack of effective prevention programming available for these high risk groups where the impact is the most devastating
Increased attention to community prevention efforts by the Federal Government highlights the limited effectiveness of these programs due to their narrow focus on the contents of programming development. The process whereby programs are adopted and implemented within the communities has not been examined.
The significant reduction of substance abuse throughout the United States will require the adoption of prevention strategies that include the following components at the local and national levels.
First, at the local level, strategies should involve the mobilization and empowerment of the community. This should include: families and peers, sound school curricula and policies, extra-curricula activities for youth, neighborhood solidarity, churches, private and voluntary organizations, law enforcement, the media and, responsible governmental agencies. Equally important are the availability of training and technical expertise, and accessible community-sensitive resources.
Second, at the national level, effective prevention policy requires strong leadership and support to fashion a coordinated directive to inspire and mobilize understanding of the war against substance abuse. This centralized leadership will work with communities, industry, the private and voluntary sectors, and the media to construct effective strategies and legislation to provide adequate re sources to re-enforce local efforts. Further, it is imperative that national initiatives merge alcohol and other abused substances into one policy statement.
Finally, there must be a clear realization on the part of policy makers that as an emerging discipline, prevention strategies and programs are part of a long-term process requiring on-going and increasing financial support by the Federal Government which is commensurate with those resources directed to law enforcement and interdiction efforts.
The committee's examination of prevention policy and programming addresses the elements essential to effective prevention strategy, including understanding risk and protective factors, the importance of community empowerment, the identification of population groups disproportionately affected by drug abuse, but not afforded access to appropriate resources so as to receive assistance, and allocation of programming funds and the policy decisions that direct it.
ONDCP, op. cit., September 1990, p. 23.
10 Mark Miller, "Bennett's New Optimism: The Evidence is Mixed.” Newsweek, March 12, 1990, p. 32.