May 9, 2000
The Honorable Senator Joseph R.
Mr. Chairman, I want to thank you for convening this hearing today to focus on the resurgence of heroin use among youth and call attention to the havoc it is wreaking throughout this country – in urban centers, small cities, leafy suburbs and rural areas.
We're going to hear some tough testimony today. Perhaps the toughest will be from Marie Allen, whose daughter Erin died of a heroin overdose at the young age of 21.
Mrs. Allen testified at a hearing in Delaware back in November. Hers is a heartbreaking story and I want to commend her for coming here to share it with us today.
In 1991 I published a report warning that heroin was making a comeback. I wish that I had been wrong.
Today there are nearly one million hardcore heroin users in the United States. But that is not the number that worries me most. The numbers that worry me most are the indicators that heroin use is on the rise among kids:
The average age of first-time heroin use is down.
Heroin-related emergency room visits involving kids (aged 12 to 17) are up more than 720 percent in the last ten years and nearly 250 percent in the last two years alone.
And in the first half of 1999 in New Castle County, Delaware, there were 71 heroin-related overdoses, ten of which resulted in death. Fifteen of these overdoses involved teenagers, including one as young as 14.
Why is heroin making a comeback? There is always a drug of the moment. In the mid-1980s it was crack. In the mid-1990s it was methamphetamine. Today it is heroin. Tomorrow it will probably be ecstasy. But why heroin now?
There are two simple reasons: price and purity.
Now that heroin is up to 90 percent pure in some cities -- including Philadelphia, which is the source for much of the heroin used in my home state of Delaware -- users can get high by smoking, snorting or inhaling the drug, making it much more attractive to teens and young adults. As long as heroin stays as pure and as cheap as it is now, there is a great risk of this problem getting worse.
So what should we do? Clearly, there is no silver bullet to this problem, but let me talk about six steps which I think are necessary.
1) Invest more in prevention. The federal government is helping to fund Community Anti-Drug Coalitions -- which Chairman Grassley and I joined to create three years ago – in 124 communities. They should be in every community. These groups can help educate parents about the rise of heroin addiction, about what signs to look for if their kids are doing heroin and about where to go to get help if they are. They can also educate kids about the dangers associated with all drugs, but particularly with heroin.
2) Treatment tailored to a patient's needs. Short-term treatment programs are little more than detox. All the research shows that the longer someone stays in treatment, the greater the likelihood of staying clean. We should make sure that affordable treatment is available for those who need it, and that it is what that individual patient needs. For high school students, that means a place like Phoenix House where they can continue going to school.
3) Reauthorize Drug Courts. Kids who get into trouble with drugs generally do not belong in jail – they belong in treatment. There are now 482 drug courts, including 96 juvenile drug courts throughout the country. We should make sure that every community that needs and wants a juvenile or adult drug court can have one.
4) Research. Ten years ago I asked the question, "If drug addiction is an epidemic, are we doing enough to find a medical ‘cure'?" That led to creating the Medications Development Division at the National Institute on Drug Abuse, dedicated to unleashing the tremendous powers of medical science to find a medical cure for this social and human ill. A few years ago, I proposed that we should spend $10 billion over a decade to develop pharmacotherapies. I still believe that that would be money very well spent.
5) Treatment for prisoners. In 1999, more than 500,000 inmates were released from State and Federal prisons. An estimated 70 to 85 percent of State inmates are in need of drug treatment, but only 13 percent receive it. The statistics are a little better in Federal prisons where 31 percent of inmates need treatment and 10 percent are receiving it. We need to treat prisoners before they are released, not only for their good, but for the good of society. Unless they beat their addiction problem, it will likely only be a matter of time before they re-offend.
6) Fund Plan Colombia. The pure heroin that is wreaking havoc on the East coast comes from Colombia. This is a new phenomenon; it has only been in the last seven years or so that the Colombians have been in the heroin business. Right now, a bill to help the Colombian government eradicate coca and poppy is stalled in the Senate. While this is not the silver bullet to stop our domestic demand for drugs, I would argue that making a dent in the Colombian heroin trade can have an impact on price and purity – the two factors that have changed the face of the American heroin addict. If we can do something to decrease the purity and increase the price so that heroin can not be snorted or smoked, then we should do it.
I look forward to hearing from all of our witnesses and I welcome you here today.