"What Drug Policy Reform Looks Like": Director's Remarks at the National Press Club
Remarks of Director Gil Kerlikowske – As Prepared for Delivery
The National Press Club
Thank you all for joining me here today.
There are many people in this room I want to thank, but let me begin by thanking the National Press Club for inviting me here today. I very much value this forum and this opportunity, since drug policy is a complex public health and public education issue.
Bob Weiner, former chief spokesperson for ONDCP during the Clinton Administration, is also here today. Bob, thank you for your continued energy and commitment to the drug issue over the years and for helping us come together.
There are a few other folks in this room and at this dais, and I will get to them in a moment. But first, I know many of you are eager to hear from me about one thing in particular.
As you know, possession of small amounts of marijuana by an adult became legal in Colorado and Washington. Those initiatives—and there are differences between them—present us with some complex questions. Above all, though, it bears repeating that the Justice Department’s responsibility to enforce the Controlled Substances Act remains unchanged. Neither a State nor the Executive branch can nullify a statute passed by Congress.
As the Department of Justice has noted, Federal drug enforcement resources prioritize and target the serious crimes of drug dealing, violent crime, and trafficking.
Let us be clear, however: the law enforcement officials who have sworn an oath to uphold Federal law will continue to pursue drug traffickers, drug dealers, and transnational criminal organizations that weaken our communities and pose serious threats to our Nation.
Too often, discussions about marijuana dwell on the issue of legalization and whether making the drug more widely and easily available would make the problem go away. But the legal status of marijuana, including enforcement of existing laws, is a matter for the Department of Justice, and DOJ’s enforcement of the Controlled Substances Act remains unchanged.
Nor should we lose sight of the fundamental fact that using marijuana has public health consequences, and the most responsible public policy is one that restricts its availability and discourages its use.
I recognize that the marijuana debate has taken up quite a bit of media space. But now I want to turn to something that affects most Americans – a subject that the Obama Administration has been focused on for the past four years and will remain focused on for the next four years: Achieving real, evidence-based drug policy reform to reduce both drug use and its consequences.
More and more, the debate about drug policy in America has become extremely polarized in recent years. On one side are advocates who believe that legalization is the only path toward drug policy reform. Legalization is often described as solving Mexico’s transnational crime problem and creating a windfall of tax money, along with many other benefits.
And on the other hand is the “tough on crime,” enforcement-centric “war on drugs” approach – one that treats addiction primarily as a criminal justice problem despite an ever-growing body of evidence that this approach is counterproductive and ineffective.
But slogans and sound bites do not make responsible public policy, and neither of these extreme positions represent a 21st century approach to this complicated public policy issue. In fact, if you can fit a policy on a bumper sticker, chances are it’s not the right approach.
So if we oppose both drug legalization and a “war on drugs,” what shape should drug policy reform take? The answer is right here in this room.
I’ve invited several pioneers here who have dedicated their lives to mitigating the harm that substance use does to our Nation—and particularly, our youth.
They stand in the vanguard of true drug policy reform, and what they’re doing doesn’t look much like a war or legalization. Their work goes unrecognized, so today I’d like to help give them a voice in this national debate.
A key aspect of drug policy reform involves the healthcare profession – nurses, nurse practitioners, physicians, psychologists and psychiatrists. These professionals work to safeguard and improve our health in so many areas, and it makes sense that they should play a role in preventing a chronic disease that has touched almost every American in some way—addiction. In reality, we cannot arrest and incarcerate our way out of the drug problem.
If the average individual meets with a healthcare provider annually -- and we know that addictive disorders are progressive diseases -- then doesn’t it make sense to take that opportunity to talk about substance use?
That annual meeting with a health provider can be a key intervention point for stopping a substance use disorder from progressing.
But for that to happen, we must provide healthcare professionals with the tools they need to intervene early, refer an individual to treatment if necessary, and help individuals sustain their recovery.
From this perspective, the American Society of Addiction Medicine is a key partner in our efforts at drug policy reform. That is why I have asked Dr. Kelly Clark, who sits on ASAM’s Board of Directors, to be here today.
Dr. Clark has devoted her career to public health. She is now helping steer an organization that pioneers the study of addiction, the science of understanding addictive disorders, and the most effective methods of preventing and treating substance use disorders.
ASAM’s core purpose is to improve the care and treatment of people with the disease of addiction and advance the practice of Addiction Medicine.
The group recently developed a course to train physicians in proper opioid prescribing through FDA’s Risk Evaluation and Mitigation Strategies program (REMS).
This program will make sure prescribers understand addiction, proper opioid prescribing, and pain management. Physicians play an important role in our efforts to reform drug policy – by first and foremost making sure that society recognizes drug abuse as the public health issue it is.
Ideally, we would like every prescriber to take this course. We aren’t there yet, but ASAM is taking an important first step by making their program available to its members and to other prescribers.
As a result of work by Dr. Clark’s team and many others, this Administration has taken unprecedented actions to treat substance use disorders as a public health issue, not just a criminal justice issue.
Already, we spend more on drug treatment and prevention than we do on U.S. domestic drug law enforcement and incarceration.
Just last week, the President’s Budget contained a request for Congress to increase funding for treatment by $1.4 billion over the FY 2012 amount. This is the largest such request for an increase in treatment in two decades.
We’re also expanding under recognized programs such as Screening, Brief Intervention, and Referral to Treatment, which trains doctors to identify the signs of problematic substance use early, before it becomes a chronic disorder or a criminal justice problem.
Our country is dealing with what the CDC has called an epidemic of prescription drug abuse. It’s hard to believe, but more people die in this country from prescription drug overdoses than from cocaine and heroin overdoses—combined.
In 2010, there were 40,000 drug-induced deaths in America. More than 22,000 of those deaths involved prescription drugs.
But we are making headway against this epidemic. Young adult usage is the lowest in a decade. And while far too many people continue to lose their lives to prescription drugs, I believe we will be able to reverse this trend.
The Obama Administration is committed to supporting progressive, evidence-based programs that can make a real difference, right away.
For the first time, we’re supporting and working to expand the use of naloxone – a lifesaving overdose-reversal drug – so that first responders are prepared to safely handle individuals experiencing life-threatening opioid overdoses and help prevent more deaths associated with our Nation’s prescription drug abuse epidemic.
In 2010, President Obama eliminated the mandatory minimum sentence for simple possession of crack cocaine. This is the first time in 40 years that a mandatory minimum drug sentence has been repealed.
And for the first time ever, we are institutionalizing a public health approach to drug policy through the Affordable Care Act, which will require insurance companies to treat substance use disorders just like any other disease. This is revolutionary in drug policy. We estimate that with the ACA, 62.5 million people will receive health insurance benefits covering expanded substance abuse and mental health treatment services by 2020, with 32.1 million gaining those benefits for the first time. With an estimated 22 million people in need of treatment who currently aren’t getting it—that is a revolutionary shift in policy.
This is what drug policy reform looks like.
It looks like a doctor. It looks like a nurse.
It also looks like local community members coming together to solve local issues.
It looks like the Community Anti-Drug Coalitions of America, or CADCA.
General Dean, thank you for being here today.
General Arthur Dean has been the Chairman and CEO of CADCA for fifteen years, following a distinguished military career. CADCA operates on the knowledge that substance use prevention is the best—and most cost-effective—way to reduce drug use and stop addictive disorders from developing, particularly among young people.
“Just Say No” or “Your Brain on Drugs” is not effective messaging. Today, we know much more about what works – and what doesn’t—in helping young people make healthy decisions about their futures.
CADCA is practicing true drug policy reform by promoting innovative, evidence-based prevention programs with tailored solutions and messages. CADCA trains community organizers at the local, grassroots level and is proving every day that we can successfully empower young people to make healthy decisions about their future.
Through the White House and with the support of Congress, we fund hundreds of coalitions through the Drug-Free Communities Support program. Each of these coalitions leverages Federal funds to create tailor-made, local solutions that resonate with people in a given community. Prevention not only makes sense, it helps young people grow up healthier, smarter, and better prepared to compete in an increasingly global marketplace.
Emphasizing prevention over incarceration. This is what drug policy reform looks like.
Drug policy reform also involves speaking up as an individual in recovery – so people can see that, yes, successful people also suffer from the disease of addiction.
Last year, I spoke to a group of leaders in the recovery community at the Betty Ford Center, one of the country’s longest-running and best-known treatment facilities.
I was inspired by those in long-term recovery whom I met, and I asked everyone in recovery to speak out; to share their stories—because by celebrating recovery, we can lift the stigma that unfortunately still surrounds addictive disorders.
Some leaders in America’s recovery community have taken up the important task of speaking out about recovery, and I have been so impressed by their commitment to raising awareness and lifting the stigma.
One of those leaders joins us today—Devin Fox, the Executive Director of a growing organization called “Young People in Recovery.”
Devin has shared his story with others, but I want others to hear it as well. Devin started using drugs when he was 18 as a freshman in college. Soon, his binge drinking and marijuana use progressed to using meth when he was 20. He did not ask to become afflicted with the disease of addiction. But today, Devin is in long term recovery from drugs and alcohol and giving back to the recovery community.
Devin has since graduated with a Masters in social work and is working with New Jersey’s Division of Mental Health and Addiction Services as a Recovery Advocate. He is demonstrating that people who suffer from substance use disorders deserve a chance to get better. And that Americans living with this disease can reach their maximum potential.
Devin’s story is not unique. He is just one of 23 million Americans in recovery, and part of a growing movement to lift the stigma associated with this disease. It’s because of people like Devin that we’ve established the first ever branch at the White House Drug Policy Office to support Americans in Recovery and help remove the barriers they often face to full employment and participation in our communities they deserve.
Devin, thank you for all of your work on behalf of the recovery community, and for joining us here today.
Devin’s work reminds us that addiction is a disease that does not discriminate by age. It doesn’t discriminate by gender, race, or socioeconomic status. But the more we are able to bring discussion of addictive disorders into the light of day, the more readily we can understand and treat them.
Unfortunately, we have to remember that many people charged with drug-related crimes are often ill – afflicted with an underlying substance use disorder. Many of these people don’t need jail time. They need treatment, and they deserve a chance to recover and change their lives.
That’s why this Administration is working to expand innovative programs like drug court that divert non-violent offenders into treatment instead of prison. In the drug court program, drug offenders are provided with treatment services and monitored closely by a judge, who holds them accountable and either rewards them for staying clean or sanctions them for not holding up their end of the bargain.
By giving non-violent drug offenders a chance to reclaim their lives through treatment rather than wasting away in prison, we can begin to break the cycle of drug use, crime, and incarceration. This kind of reform not only saves lives, it saves taxpayer dollars and reduces incarceration rates in America.
So today I’m proud to announce that ONDCP is awarding a $1.4 million grant to the National Association of Drug Court Professionals, the country’s leading drug court organization, to train drug court professionals who work to divert non-violent drug offenders into treatment instead of prison.
Already, because of the work of NADCP thousands of non-violent offenders are diverted into treatment instead of prison through more than 2,700 drug courts across America. We hope this new grant will improve their work to continue this progress in drug policy reform.
This is what drug policy reform looks like.
Dr. Clark, General Dean, Devin Fox—they represent just some of the innovations to drug policy we are achieving today. It’s a shift toward prevention, treatment, and recovery services; toward criminal justice reform; toward research and science; and toward evidence-based programs that strengthen public health and safety.
Drug policy reform is not easy. There is no quick fix solution.
What I’ve outlined today doesn’t lend itself to a slogan that fits on a bumper sticker. Nor does it make for catchy headlines.
But this approach works. Each year, we’re diverting more than 100,000 people into treatment instead of prison through drug courts.
For the first time in decades, the U.S. prison population is declining. Cocaine use is dropping, as are overdose deaths from the drug. The most recent data (from 2011) show that the number of meth users is down 40 percent since 2006.
We’re beginning to turn the corner on our Nation’s prescription drug abuse epidemic. And increasingly, law enforcement and the public health community are working together and getting smarter about how to reduce drug use and its consequences in America.
I should note that this strong partnership between law enforcement and the public health community isn’t unique to drug policy. We also see this partnership in today’s debate about gun violence. That is why when President Obama announced 23 executive actions to reduce gun violence in America, he also included actions to address the role mental health plays in reducing this challenge.
These are common sense steps supported not only by law enforcement, but also by the public health community.
Let me close by further telling you what drug policy reform looks like. 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.
Drug policy reform should be rooted in neuroscience—not political science. That’s what a 21st century approach to drug policy looks like.
And 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 will receive it; one where our children feel safe because we have done everything in our power to keep weapons out of the hands of criminals and the mentally ill.
Thank you all for coming today. I’m happy to take any questions you may have.