ONDCP Blog

  • Alcoholics Anonymous: Original Twelve Step Recovery Program

    Alcoholics Anonymous ImageAs part of national efforts to raise public awareness about recovery and maintain dialogue with diverse recovery community stakeholders, ONDCP Director Gil Kerlikowske visited the General Service Office of Alcoholics Anonymous (A.A.) in New York City. The Director toured the organization’s archives and met with the Board of Directors of A.A. World Services, Inc. (A.A.W.S.).

    Founded in 1935, A.A. introduced the now widely known concept of the Twelve Steps as a path to recovery. The Twelve Steps have subsequently been adopted to support people recovering from a host of other addictions (e.g., Narcotics Anonymous), the family members of those with or in recovery from addiction (e.g., Al-Anon, Alateen, Nar-Anon), and individuals with dietary or weight issues (e.g., Overeaters Anonymous). A.A. estimates that as of January 2011, there were nearly 58,000 autonomous A.A. groups and 1.3 million members in the United States alone. Worldwide, it is estimated there are nearly 108,000 groups and 2.1 million members.[i]

    Alcoholics Anonymous has a singleness of purpose. According to A.A.’s Fifth Tradition, “each group has but one primary purpose—to carry its message to the alcoholic who still suffers.” This does not mean that people who take part in A.A. meetings don’t have other problems, including addiction to drugs.  Rather, it reflects the understanding that it is through a singleness of purpose that A.A. can best accomplish the mission for which it was established. People with co-occurring alcohol and drug problems are welcome to take part in A.A. meetings, provided the focus of their participation is addressing their alcohol problem. Research indicates, in fact, that approximately one in eight alcoholics are also addicted to drugs, and that more than half of those addicted to drugs are also addicted to alcohol.[ii]

    Prior to meeting with the A.A.W.S. Board, Director Kerlikowske toured the A.A. Archives, which feature letters from U.S. presidents recognizing Alcoholics Anonymous for helping countless Americans regain health and happiness through its program of recovery from alcoholism. The archive also features the Lasker Award, presented to A.A. in 1951 by the American Public Health Association “in recognition of its unique and highly-successful approach to … alcoholism;” and a copy of the Hughes Act, the 1970 Congressional Bill that recognized alcoholism as “an illness or disease that requires treatment.” The bill also provided for the establishment of the National Institute on Alcohol Abuse and Alcoholism and was followed by legislation leading to the creation of the National Institute on Drug Abuse.

    During the Board meeting, Director Kerlikowske described ONDCP policies, priorities, and activities in the recovery domain. After concluding his remarks, a member of the A.A. World Services staff explained the manner in which A.A. cooperates with professionals in order to help serve the still-suffering alcoholic. A discussion of potential avenues for cooperation between ONDCP and A.A. ensued. Following the discussion, the A.A.W.S. Board presented the Director with a signed copy of A.A.’s basic text, Alcoholics Anonymous, commonly known as “The Big Book.” The Library of Congress recently included the Big Book in an exhibition entitled “88 Books that Shaped America.”

    As an organization, A.A. holds no affiliation with any outside group and does not endorse or oppose any cause. However, it does interact with professionals in a number of ways. For example, it accepts referrals. According to the most recent A.A. Membership Survey, 40 percent of members were referred to meetings by a healthcare professional. The group also encourages members to be of service to other alcoholics.  Members  organize meetings and share their experiences and insight with those under professional care seeking to recover from alcoholism. Members also conduct informational meetings or presentations for professionals interested in learning what A.A. is and what it is not.

    Those wishing to learn more about A.A. can contact a local central office or intergroup for open A.A. meeting information; observe open A.A. meetings and talk to people in A.A. about their recovery and A.A. experiences; read A.A. literature, including The Big Book of Alcoholics Anonymous, Twelve Steps and Twelve Traditions, and numerous pamphlets designed specifically for professionals; or subscribe to the free About A.A. newsletter or the monthly magazine A.A. Grapevine or its Spanish-language edition,La Viña.



    [i] Alcoholics Anonymous (2012). A.A. Fact File. Alcoholics Anonymous General Service Office. New York, New York.. Original Copyright 1956.

    [ii] Falk, D., Ye, H., Hiller-Sturmhöfel, H. (2008). An Epidemiologic Analysis of Co-Occurring Alcohol and Drug Use and Disorders: Findings From the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Alcohol Research and Health. P. 106. (http://pubs.niaaa.nih.gov/publications/arh312/100-110.pdf)

     

     

  • Drug Policy Reform Through Alternative Courts

    Matthew Perry and Director Kerlikowske chat after meeting to discuss drug policy reform. 

    The White House has just released a drug policy reform plan that outlines science-driven solutions to the drug problem in America.  About eight years ago, I began speaking publicly about one of the solutions the Administration supports—a program called drug courts.

    Over time, I learned that drug courts are a wonderful solution to one of the biggest problems facing our criminal justice system: people suffering from substance use disorders who are caught in the cycle of arrest and incarceration. Many of these individuals require treatment, not a jail cell, and drug courts provide them a means of getting the treatment they need.

    I have testified before Congress several times about the value of drug courts, and I have served as a spokesperson for the country’s leading champion for drug courts, the National Association of Drug Court Professionals. Today, I had the chance to meet with the President’s drug policy advisor, Gil Kerlikowske, and several officials from the Administration to discuss the role of drug courts in the President’s plan to reform national drug policy.

    ONDCP Director Gil Kerlikowske, Matthew Perry and Administration officials meet to discuss drug courts and the President's plan for drug policy reform.

    The Nation’s more than 2,700 drug courts treat the disease of addiction instead of incarcerating those who are struggling with it. Research has shown that drug courts are one of the most effective ways to keep people out of jails and prison, reduce crime, and save money. In fact, 75 percent of drug court graduates remain arrest-free at least two years after leaving the program, and studies examining long-term outcomes of individual drug courts have found that reductions in crime last at least 3 years and can endure for over 14 years.

    Nationwide, for every $1 invested in drug court, taxpayers save as much as $3.36 in avoided criminal justice costs alone. Studies have shown that when other cost offsets are considered, such as savings from reduced victimization and healthcare costs, benefits can range up to $27 for every $1 invested. States and communities are investing in drug courts: For every dollar the Federal Government spends on drug courts, $9 was leveraged in state funding.

    I know firsthand how difficult and painful addiction can be – I’ve lived through it. Now I’m proud to be in long-term recovery from addiction, and I’m proud to be an advocate for a program that’s finally breaking the vicious cycle of addiction, arrest, and incarceration.

    In my meeting with Director Kerlikowske today, I learned about the President’s plan to reform drug policy, which emphasizes treatment and prevention over incarceration. The President’s plan is based on neuroscience, not political science—a philosophy perfectly embodied by the drug court program.

    Matthew Perry is an actor and Celebrity Ambassador for National Association of Drug Court Professionals.

  • Drug Policy Reform In Action: A 21st Century Approach

     

    The President has outlined his vision of an America built to last—where an educated, skilled workforce has the knowledge, energy and expertise to compete in the global marketplace. Yet--for far too many Americans--that vision is limited by drug use, which not only diminishes the potential of the individual, but jeopardizes families, communities and neighborhoods.

    The economic costs of drug use are enormous: In 2007 alone, illicit drug use cost taxpayers more than $193 billion in lost productivity, healthcare, and criminal justice costs. But the human costs are worse. Nationwide, drug-induced overdose deaths now surpass homicides and car crashes as the leading cause of injury death in America.

    We are not powerless to address these challenges. And as recent data has shown, we are not unable to reverse these trends. Prescription drug abuse is beginning to decline. Cocaine use and related overdoses are dropping. And recent data show the nation’s prison and jail population dropping for the third straight year.

    Today we are releasing a science-driven plan for drug policy reform in America to build upon this progress. This 21st century drug policy outlines a series of evidence-based reforms that treat our Nation’s drug problem as a public health issue, not just a criminal justice issue. This policy underscores what we all know to be true: we cannot arrest or incarcerate our way out of the drug problem.

    America’s 21st century approach to drug policy is built on decades of research demonstrating that addiction is a disease of the brain—one that can be prevented, treated, and from which people can recover. The 2013 Strategy reflects this understanding by emphasizing prevention and treatment programs over incarceration, by replacing “tough on crime” with “smart on crime” and by making access to treatment a reality for millions of Americans. In fact, the President’s 2014 budget requests $1.5 billion more for treatment and prevention programs compared to 2012 – the largest requested increase in at least two decades. 

    Drug policy is not about leaving Americans to fend for themselves. It’s about helping women with substance use disorders get access to prenatal care so their children can get a healthy start in life. It’s about showing teenagers a healthy path to adulthood so they can succeed as productive members of society with the skills they need to compete in the 21st century. It’s about giving a person who struggles with addiction an opportunity to go to treatment and receive support in recovery. It’s about the historic expansion of mental health and addiction treatment to 62 million Americans who need help provided by the Affordable Care Act.

    This is what drug policy reform looks like, and that’s what is in the Strategy we are releasing today.

    Click here to learn more about the Administration’s plan for drug policy reform.   

     

  • Protecting Our Environment and Our Health: Earth Day + National Take-Back Day

    Is your medicine cabinet filled with old bottles of half-used prescriptions? They might seem harmless, but that medicine can spell disaster if misused, and disposing of prescription drugs the wrong way can harm our Nation’s water supply and our environment. That’s why today on Earth Day, we want to encourage you to participate in Take Back Day on April 27th to get rid of old medications and keep your family, and the planet, safe.   

    Clean out your medicine cabinet

    A medicine cabinet full of unneeded or expired medicine poses a risk to your loved ones, especially young people. In 2010, prescription drugs were involved in over 22,000 deaths. Of those, over 16,000 involved opioid painkillers like Vicodin® and OxyContin®.[1]

    In the United States, more people die from prescription drug overdoses than from heroin or cocaine overdoses —combined.[2]

    According to a recent Monitoring the Future study – the Nation's largest survey of drug use among young people – prescription drugs are the third-most abused category of drugs after marijuana. In addition, the latest National Survey on Drug Use and Health shows that over 70 percent of people who abused prescription pain relievers in the past year got them from friends or relatives the last time they used them.[3] Over 50 percent of teens in a 2008 survey said it was easy to get prescription medications from their parent’s medicine cabinet.[4] Getting rid of those old medicines is an easy step you can take to remove a temptation—and maybe save a life.

    Be careful about the medicines you flush

    You might think flushing all your old pills down the toilet is the best way to dispose of them, but that’s not necessarily true. Medicines that go down the drain end up in our water supply, where they can damage the environment and harm animals.[5] We don’t know if these drugs in the water supply might also harm people, but experts believe antibiotics in the water might make it harder to treat certain pathogens in the future.[6] To make sure, visit the FDA’s page on safe drug disposal guidelines to find out which medicines they recommend flushing.

    President Obama and the White House Council on Environmental Quality are committed to clean water, and want to reduce contaminants in drinking water, including contamination from improperly disposed medications. So we’re encouraging everyone to participate in the Sixth National Drug Take-Back Day on April 27. On Take Back Day, local law enforcement and community groups team up with the Drug Enforcement Administration to collect unused medications so they can be disposed of safely. Visit the Take Back Day website to find a collection site near you.

    Safe medication disposal tips

    Can’t make it to Take Back Day? Here is how to dispose of prescription drugs safely:

    • If there are no specific disposal instructions on the medication, take it out of its original container and mix it with an undesirable substance like coffee grounds or cat litter to discourage people and animals.
    • Place the mixture in a sealable bag and put it in the trash.
    • To protect your privacy, before throwing out a medicine container, scratch out all identifying information on the prescription label to make it unreadable.

     

  • Director Kerlikowske Speaks at National Press Club

     

    This afternoon, Director Kerlikowske delivered remarks at the National Press Club about drug policy reform and the Administration’s 21st century approach to drug policy. He was joined by three leaders who exemplify the drug policy reform the Obama Administration is undertaking—Dr. Kelly Clark, American Society of Addiction Medicine (ASAM) Board of Directors; General Arthur Dean, Chairman and CEO of the Community Anti-Drug Coalitions of America (CADCA); and Devin Fox, Executive Director of Young People in Recovery.

    In his remarks, Director Kerlikowske spoke about the steps the Administration has taken to advance drug policy reform and the work that lies ahead—particularly in the historic expansion of treatment programs requested in the President’s 2014 budget request and required by the implementation of the Affordable Care Act.

    ASAM, CADCA and Young People in Recovery each represent a critical piece of the Administration’s approach to drug policy reform. As an organization dedicated to improving the care and treatment of people with addictive disorders, ASAM trains and educates physicians to enable them to treat substance use disorders like other chronic diseases. With its tireless work implementing evidenced-based prevention programs to communities across the country—and the world—CADCA has been a steadfast partner in preventing substance use disorders before they begin. As an advocate for recovery, Devin Fox is working to lift the stigma associated with addiction by speaking out and strengthening networks of support for other young people sustaining long-term recovery from drug or alcohol dependence.

    Dr. Clark, General Dean and Devin Fox represent a broader shift in American drug policy—one that emphasizes prevention, treatment and recovery over incarceration; that pursues criminal justice reform, and is grounded in research and science. It’s part of the President’s broader plan to build an America to last—one where our workers are skilled to compete in a global marketplace, where those who need mental health and substance use treatment receive it; one where our children grow up healthy and safe.

  • FDA Takes Action on Prescription Drug Abuse

     

    Yesterday, the Food and Drug Administration (FDA) took an important step in addressing America’s prescription drug abuse epidemic.

    The FDA announced that it approved updated labeling for reformulated Oxycontin that describe the drug’s abuse-deterrent properties, the first time such a claim has been approved by the agency. FDA also said it will not accept or approve generics of the original OxyContin formulation, which lacks these properties.”

    For over a century, the FDA has applied the principles of science, evidence, and common sense to protect public health and safety in America. Yesterday’s action demonstrates yet again that when it comes to our Nation’s prescription drug abuse epidemic, there are significant and important steps we can take to save lives and protect public health.

    This announcement builds upon already unprecedented actions by the Administration to drive down the number of Americans affected by prescription drug abuse. Director Kerlikowske and ONDCP commend the FDA for its work to keep non abuse-deterrent formulations of this drug from reaching the marketplace while continuing to ensure access to powerful opioid analgesic drugs that – when properly used and prescribed –provide relief to those suffering from acute and serious illnesses.

    The Centers for Disease Control and Prevention has classified prescription drug overdoses as an epidemic. National data show that by 2010, drug overdose deaths were the second leading cause of injury death in America. Additionally, the overall drug overdose death rate in the United States roughly tripled between 1991 and 2011, and in 2007 about 100 people per day died from drug overdoses in the U.S.

    To address the threat of prescription drug abuse and diversion while also protecting legitimate access to these drugs for those suffering from pain, the Administration released Epidemic: Responding to America's Prescription Drug Abuse Crisis in 2011.  This action plan provides a national framework for reducing prescription drug diversion and abuse by supporting education for patients and healthcare providers, recommending more convenient and environmentally responsible disposal methods to remove unused medications from the home, supporting the expansion of state-based prescription drug monitoring programs, and reducing the prevalence of pill mills and doctor shopping through enforcement efforts.

  • Guest Post: Michael Banyard’s Story, Part 3

     

    In June 2012, National Drug Control Policy Director Gil Kerlikowske visited the Betty Ford Center, one of the Nation’s oldest and most recognized addiction treatment facilities. There he gave remarks to a crowd of leaders in the field of recovery. In the audience were two special guests—Michael Banyard and Federal District Court Judge Spencer Letts. In his remarks, Director Kerlikowske mentioned Banyard’s improbable—and inspirational—journey from crack cocaine dependence and homelessness, to prison, to a successful sentence appeal, to the chambers of a federal district court judge and completion of his GED.                     

    Read Part 1and Part 2 of Michael Banyard’s story.

    I was very successful and rose to the occasion. Things went so well that Kurt Streeter of the L.A. Times wrote a front page, two-part article that covered the judge’s and my friendship and the work we were doing with the youth at S.E.A. High School. 

    It was clear that, like Judge Letts, I too was a person who loved helping people. I was not a homeless drug addict who could never get it right, but someone who could really be happy if I continued to strive for perfection. I was happy I was making a difference in the life of these teens.

    I was so externally focused, when all was done and accomplished with the teens, I began to spend a lot of time alone. Even with my strong desire to do right, something was still missing, and I couldn't figure out what it was. After the students graduated, I went on a journey to find my value and esteem. There was still an unfulfilled emptiness. 

    Things got worse than they had ever been. I ended up going to four more drug programs trying to figure this thing out. Judge Letts still never gave up. He continued to encourage me and let me know that he believed in me, even at my lowest point. My experience taught me that reaching the bottom was not a process of spiraling down until you just splat...but rather, when you reach a real low place and get comfortable there. An ugly place where you feel you can never escape from.

    I was there and gave up totally but Judge Letts never gave up on me. He continued to be my friend through it all. 

    A time came when I knew for certain that I did not, nor could not, find the answer alone, and I called the Judge and told him I did not know what to do. I told him I was willing to do whatever he asked of me.

    The Judge reminded me of when his clerk Nancy Webb had mentioned to me that I should try going to a place called the Dream Center

    Nancy had seen Pastor Matthew Barnett on the Joyce Myers show talking the about the Dream Center's Discipleship Program and she felt it was a suitable place for me. So the Judge encouraged me to try what Nancy had already suggested and I did. 

     

  • The President’s FY 2014 Budget: Supporting A 21st Century Drug Policy

    Today, the President released a Budget that shows how we can invest in the things we need to grow our economy, create jobs, and strengthen the middle class while further reducing the deficit in a balanced way.  Everything the President does is geared toward strengthening the middle class by creating jobs and growing the economy. That’s his North Star, and that’s why today’s Budget details how we can invest to attract more jobs to our shores, equip our people with the skills they need, and ensure that hard work leads to a decent living—without adding a dime to the deficit.

    Across America, drug use and its consequences place obstacles in the way of the President’s plan to foster healthier, safer, and more prosperous communities.  In fact, in 2007 drug use cost American taxpayers $193 billion in lost productivity, healthcare, and criminal justice costs. There is also a connection between drug use and unemployment.  For example, research indicates that cocaine use tends to lower the likelihood of being employed by 23 to 32 percentage points, while marijuana use lowers it by 15 to 17 points.

    To reduce the significant burden of our Nation’s drug problem on our people and our economy, the President’s Budget supports a 21st century approach to drug policy that acknowledges drug use is a public health issue, not just a criminal justice one. Time and again, research has shown that prevention, treatment, early intervention in health settings, and smarter law enforcement efforts, working together, can make a real difference in saving lives and making our Nation safer and stronger. That’s why the Budget the President released today requests $25.4 billion in Fiscal Year 2014 to support evidence-based drug control programs – an increase of about $1 billion over FY 2012.

    Most notably, the President’s Budget includes a request for an increase of $1.5 billion over the FY 2012 level to fund drug treatment and prevention services in America – a 16 percent increase over FY 2012.  As a result, the President’s Budget requests more for treatment and prevention – $10.7 billion – than for Federally-funded domestic drug law enforcement and incarceration – $9.6 billion. This is what a 21st century approach to drug policy looks like.

    For more details on the President’s drug budget, click here

    To read more about the President’s 21st century approach to drug policy, click here.  

  • Director Kerlikowske Joins Secretary Napolitano on Southwest Border

    This afternoon, Director Kerlikowske joined Secretary of Homeland Security Janet Napolitano in Tucson, Arizona. They inspected border security operations at the Southwest border, met with state and local stakeholders, and highlighted the significant progress achieved at disrupting illegal drug trafficking and improving operations along the Southwest border. 

    As part of the visit, Director Kerlikowske released a progress update on Administration efforts to strengthen border security. Some of the highlights include:

    • Increased weapons and drugs seizures. During 2009-2012, the Department of Homeland Security (DHS) seized 39 percent more drugs, 71 percent more currency, and 189 percent more weapons along the Southwest border as compared to fiscal years (FY) 2005-2008.
    • More boots on the ground. DHS has increased the number of personnel on the ground from approximately 9,800 Border Patrol agents in 2001 to more than 21,000 today.
    • Technology and infrastructure. U.S. Customs and Border Protection (CBP) has expanded the use of Unmanned Aircraft Systems from California to Texas and has completed 651 miles of fencing along the key trafficking areas. 
    • Reducing drug demand. As part of its commitment to reduce the demand for drugs in the U.S., ONDCP has funded 18 Drug-Free Communities within 100 miles of the border in Arizona, California, New Mexico, and Texas. These coalitions provide outreach services to young people to prevent drug use before it begins.  
    President Obama announced in January of this year that strengthening border security is one of the key principles for common sense immigration reform. These principles will continue to build upon this progress by investing in the ports of entry; helping our officers and agents focus on public safety threats; making it harder for transnational criminal organizations to operate; encouraging immigrants to pursue a pathway to earned citizenship; holding employers accountable; and strengthening the integrity of the immigration system.

    The passage of the President’s proposal will help ensure that officers and agents along the border are better able to strengthen public safety and combat national security threats including drug trafficking.

    For more information on Obama Administration efforts to bolster border security and create an immigration system for the 21st century, go here. To read a fact sheet on strengthening border security, go here

  • Guest Post: Dr. Christian Thurstone, ONDCP Advocate for Action

     

    In the adolescent substance treatment program I run, 95 percent of the referrals are for marijuana, and in 2009 the number of referrals tripled. My young patients started telling me, "Doc, why would I stop using marijuana? It's medicine for my anger." I even heard parents say, "Maybe I should get my kid a medical marijuana card so they don't get in trouble for smoking pot."

    Meanwhile, new research was showing that marijuana was potentially more damaging to the developing adolescent brain than we previously thought. There are studies that show adolescents who use marijuana regularly may have an increased risk of developing psychosis[1] and may lower their IQ by up to 8 points.[2] Some people laugh at me when I explain these research findings. "That's just reefer madness," they say. But for families grappling with drug-using children, this is no laughing matter.

    I decided there was an urgent need to get out the word that marijuana is definitely NOT safe for adolescents. So over the next 3 years, I gave more than 100 talks to any group that would listen – Boy Scouts, churches, colleges, news organizations, parent groups, policy makers, professional organizations, Rotary clubs, schools, students, prevention experts, and teachers, to name a few. I also developed written materials for the Colorado Department of Education and my personal website to provide up-to-date information. 

    At heart, I am a scientist and a physician, not a public speaker. However, in 2009 only a handful of people were speaking up to protect kids from bad information about marijuana. I figured someone had to do so, and I'm glad I did.

    Today, I see signs of hope. Parents frequently say to me, "Doc, I'm worried about what marijuana is doing to my kid's developing brain." They are getting the message, and I believe more and more kids are starting to understand as well.


    [1] Hall W, Degenhardt L., Adverse health effects of non-medical cannabis use, Lancet, 2009 Oct 17;374(9698):1383-91. doi: 10.1016/S0140-6736(09)61037-0.

    [2] Meier, Madeline et al, Persistent cannabis users show neuropsychological decline from childhood to midlife, PNAS Early Edition, 2012, www.pnas.org/cgi/doi/10.1073/pnas.1206820109