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Last Updated 11/06/97 13:01
March 12, 1997 gmh JUDICIARY AND PUBLIC HEALTH 2:00 P.M. PRESIDING CHAIRMAN: Representative Lawlor MEMBERS PRESENT: SENATORS: Coleman, Upson, Gunther, Cook, Harp, Williams REPRESENTATIVES: Scalettar, Farr, Dandrow, Doyle, Jarjura, Nystrom, O'Neill, Sauer, Winkler, Dickman, Donovan, Fleischmann, Nardello, Orange, Pudlin, Ryan REPRESENTATIVE LAWLOR: The public hearing has started. Basically, by way of explanation, we have some out- of-state speakers who participated in the morning forum who will be speaking at the outset of today's meeting. Then we have members of the public who have signed up as well to speak. And normally it's our procedure in the General Assembly, although this is not the normal type of public hearing where we actually have bills before us. This is an informational public hearing. In this particular process, we are asking people to talk about their views on our existing drug policy and provide us with suggestions on how me might go about formulating more effective solutions. We are joined or will be shortly joined by members of the Public Health Committee and this is an opportunity to make some suggestions. One reminder to people who don't normally come here, everything that is said in these public hearings is re-broad cast throughout the building. So there are legislators who are not here who are listening in their offices. Also a verbatim transcript is made of all of the testimony here today and although you are not testifying on specific bills, I can assure you that the testimony will be kept with the drug policy bills as they move through the legislative process. I know Doctor Lewis has to leave early and he has a very short slide presentation, so I would like to call on Doctor Lewis first to proceed. DR. DAVID C. LEWIS: Can we dim the lights at all? REP. LAWLOR: Yes, we can. DR. DAVID C. LEWIS: Not turn them off, but just dim them a little bit. That would be helpful. First, thanks for the privilege of inviting me and my background is a medical professor and head of a research institute at Brown University, but I worked on the health care reform with the Hilary Clinton Task Force and I am aware of the research on cost benefit and treatment outcome and have also participated as the director, Medical Director, of an addiction hospital in the care of lots of drug addicts. What I am going to present today briefly, is some information on the problem, what treatment intervention does for the problem and what some of the options are for government in terms of policy and in particular, the balance between the criminal justice approach and a public health approach because we need to achieve, in my view, a better balance of these two and we need achieve more better balance with more emphasis on a public health approach. Now, the situation, as you all understand it, is emergency room visits for hard core addiction and addiction problems and drug uses are increasing. Overdoses are soaring, substantially greater and continue to go up. The need for treatment, particularly in urban areas has increased while the budgets for treatment have decreased. SEN. UPSON: Drug overdose in those two areas -- cocaine and (INAUDIBLE - MICROPHONE NOT ON) DR. DAVID C. LEWIS: Yes. And the amphetamine group and the stimulant group. Drug arrests are very disproportionate still by race and not only arrests, but incarceration and this is the incarceration rates, sentencing disparities between Black and White and they are pretty dramatic. So there are inequities in the administration of justice. Offenders are overcrowding federal prisons and others will speak to the situation in each state, but with the existing laws in many states that passed some version of "three strikes", the fastest growing new population in many of these prisons are addicted and women among them being the fastest growing of the addicted population. And you can see the trend there in the federal prison population which has continued upward since these slides were made and the Federal Drug Control budget basically has the majority of its emphasis on international interdiction and law enforcement and the minority, in demand reduction which includes treatment and prevention. And most states have followed suit. Going backwards and I want to go forward. Okay. Now, what's been in the news lately is the increase in teenage marijuana use and that's seemed to have gotten more press than anything else. It is interesting during this period of time -- I mean, the first responses were not tough enough somehow. We should toughen up and do more. But the situation is interesting for marijuana because in the same period, roughly, the people are talking about teenage marijuana use doubling, there were more arrests for marijuana possession that there were for cocaine and heroine combined. And what I am saying here is that our policy does not follow a health model and pharmacological model, but follows a historical model built on prohibition from alcohol and a kind of hangover from the prohibition of alcohol with drug prohibition. SEN. UPSON: Is that for teenagers or everybody? DR. DAVID C. LEWIS: That's for everybody. Now a lot of the force behind the criminal justice approach is to control supply. And unfortunately it hasn't worked very well. It hasn't worked for source country, it hasn't worked for interdiction and it hasn't worked on the street too well either in terms of controlling supply. This shows that cocaine prices are dropping despite the international control efforts. So the supply effort is difficult and is flawed. Another thing that is a problem with our drug policy nationally and in every state, is that this is a complex matter. An addiction really is multi- drug and multi-issue. Gambling is involved. Alcohol and tobacco, as you know, are big league products when it comes to the production of drug dependence and problems. It turns out that the strongest of all the addictions in terms of relapse rate is nicotine. Drugs that are relatively available and much less relapse with drugs like heroine or even cocaine. If we compare causes of death in the United States, there is about 2 million people that die each year, about half of that group, one million or so, die of lifestyle causes and here is the list of lifestyle causes with tobacco, heading the list. Alcohol coming next for the drugs and the elicit drugs, quite far down on the list, 20,000 versus 400,000 to tobacco. I think it is very hard to have a national drug policy that focuses mostly on so- called "illegal drugs". I don't think that makes sense to our youth, particularly when it comes to drug education. These are the attributable risks to various kinds of drug and alcohol use and as you all know, there is a very substantial health risk associate with all of this, but particularly with nicotine and with alcohol. The good news is that substance abuse treatment works and it's powerful medicine to bring down health care costs. Not only does it bring down health care costs, but it brings down cost in the criminal justice system as well and in crime. There is one study that I would like to show you which compares the different kinds of approaches and in a sense, is comparing certain criminal justice approaches with certain clinical approaches. How much money would you have to invest every year to accomplish a one percent decrease in cocaine consumption? In the comparative study done by the Rand Corporation shows you that your investment for source country, eradication of cocaine, is very high, 783 million a year and for interdiction, sealing the borders or attempting to seal the borders, 366 million. For domestic enforcement, 246 and for treatment, 34. So it's a relative bargain. Twenty-three times more cost effective than source country. What can you do on a state level? I would say that expenditure on drug treatment is probably the most effective, single community anti-drug kind of a (INAUDIBLE) that you can do. You probably save more money and you probably reduce more crime by making treatment on demand. Interestingly enough, the State of Minnesota had a consolidated plan where they increased their treatment budget trying to offset it from savings in the health system and the criminal justice system. They spent $50 million and they got 80% back within a year. And most of the return on their investment, was in DWI arrests and other arrests. In other words, the criminal justice system part or the crime related part were the biggest savings. And similarly in California, they got $7 back for the taxpayers for every dollar they invested in treatment and most of those savings were crime related savings. Some of them were health related savings. The important thing to understand about Minnesota, California, and other places where these studies have been done, is the savings are almost immediate. They recouped 80% within a year. The reason is as soon as anybody gets into treatment, it becomes an anti-crime measure. They are under cover and the crime rates drop right away. So you don't have to evaluate them one or two or three years out to see what they are doing. It's an infective intervention. And this state approves it and Minnesota and other states have had a similar experience. You have to compare your budgets. You have to know it's in the criminal justice budget and in the health budget. You have to do the kind of analytical work in the budgets so you understand how you save from one to the other. But the costs benefits and the cost offsets are very substantial. The influence on prevention is profound. We have now an education system that says don't use any drugs. We don't have an education system that says, if you do use alcohol, don't drive. We want to say, don't use alcohol, don't drink. If you do drink, don't drive. We just stop and say don't drink and teenagers are drinking. So we have this kind of try and die, what I call, "try and die" drug education. We've got to get more realistic about it and look at drug harms as well as drug use as a criteria and we have to reform our prevention and education system. Not only making treatment more available, but making education more realistic. In closing, we can take our current approach and ask ourselves three questions. Do you think we've won the war against drugs? Do you think that the current strategies are winning the war against drugs? And lastly, do you think doing more of the same will ever win the war against drugs? I maintain that we need a fresh look at a public health approach to this problem. State legislatures have to put money into this because it is cost beneficial and you will see the results, not only in the return of dollars, but in the return of healthier communities. I would like to leave with the committee four reports, which I think will be informative. The one is called, "Keeping Score" which is the report from which I got the slides that were projected. Another is called, "Fixing a Failing System - How the Criminal Justice System Should Work With Communities to Reduce Substance Abuse". Another is "Health Reform for Communities", the report that was made up by a project of the (INAUDIBLE) Johnson Foundation for the health care reform debate and last, "Implementing Welfare Reform - Solutions for the Substance Abuse Problems". So, Representative Lawlor, I would like to leave these for the use of the committee. REP. LAWLOR: Our staff will take them, Doctor. DR. DAVID C. LEWIS: Thank you. REP. LAWLOR: Thanks very much. Ladies and gentlemen, normally we don't have demonstrations in our public hearings for or against the speakers and hope you would appreciate our concern in that regard for future speakers. Was there any questions for Doctor Lewis? Representative Farr. REP. FARR: I am a little confused by some of your message. Your message seems to be that the drug situation in America has gotten worse. My understanding is that drug use is half of what it was in 1980. Then your message is it has gotten worse because we spend too much on prisons and when I look at your slides, we also spend significantly more than we ever did on treatment and education. So is your suggestion that the criminal justice system, by trying to prevent the sale of drugs, is increasing the use of drugs? Could you please reconcile those two concepts? DR. DAVID C. LEWIS: I'm not sure it's achieving society's aims. Let me say that while drug use may have been dropping, until the recent increase in teenagers, let's say during the 80's, the problems related to drug use were going up. So the use is dropping, but let's say harmful use is the main criteria we look at. So if you look what happened to the AIDS epidemic in terms of drug related AIDS, if you look at what happened to some of the crime rates related to drugs, particularly violence, including domestic violence, if you look at the problems related to drugs, they have been going up continually and hard core addiction has been increasing during the whole time. The biggest growing budgets are around the criminal justice system, not around the treatment system. As a matter of fact, managed care has pretty much decimated a big part of the treatment system, particularly for middle class addicts. So I think the data is not what you are presented to be because the drug use is not the only measure of success. Now I am not saying that the criminal justice system is the fault of the problems related to drugs. I'm saying that we haven't put enough emphasis on a public health model that could, I think, achieve a different result and a cost effective result. So I am being very pragmatic in terms of what I think will work for government and I am presenting data that show that that's a good investment and also that show that our large expenditures in the criminal justice system, particularly for incarceration, while it seems like a good thing, is not really paying off in terms of an anti-crime measure and it is certainly not paying off in terms of helping people get better from their addiction. REP. FARR: Well, we could debate this. Obviously, the crime rates are dropping in America. They are dropping in this state. The issue of the AIDS epidemic doesn't appear to me that the relationship of the change in the drug usage because the AIDS got into the community of intervenous drug users and it wasn't there and once it got in it spread. But I think the major issue is and what we ought to focus in on is where we cost effectively spend our money. The concern I have with one of the reports that we had from our own Program Review was that 58% of the people that go into drug programs that the State operates, 58% don't even complete the programs and that is sort of alarms me. When people say we need more spots and yet people aren't completing the programs right now. I know in the alcohol area there was testimony last year that in some of the de-tox units we were told that we needed more spots for alcohol de-tox and then there was testimony that some people have gone through de-tox as many as 100 times during the course of the year and I guess my concern is that how do we measure which programs we ought to be investing our dollars in, in a systematic way because I am not convinced that we are doing a very good job on that. DR. DAVID C. LEWIS: It's a good question. I think, understanding the nature of addiction, is to understand the problem of relapse. Obviously, if you de-tox somebody once and they never relapse, it would be a pretty easy score to treat addiction. We wouldn't have an addiction problem in this country, but the fact is as anybody knows who has tried to quit smoking, and who has a drinking problem and tried to quit drinking, it's not easy. So we have to really put time, effort, energy and the whole self help movement to play to try to help people. In terms of treatment outcomes, it very much depends on who goes in. So if you take a tough population like an urban street population that has a history of prison and criminal involvement, you are going to have a tougher time trying to rehabilitate these people in the treatment system. That's no surprise. If you take somebody that hasn't lost too much from their addiction, they are going to do better. So I think what you have is a system where the evaluation of the effectiveness of programs very much depends on the population they take on. And this is very important in understanding the Medicaid reform that you are going to be involved in that sometimes the outcomes reflect the work with the tougher population and they won't be as good as other programs that take care of populations that are doing better in the first place. If you then correct for those, you find basically the treatment works really well, much better than the public tends to think it does. The public tends to see the relapses. If you have an alcoholic in your family, you tend to see that they don't get better, very easily or somebody tries to quit cigarettes, you get frustrated with that or the less familiar situation to the public, is the heroine addict and cocaine addict and since it's less familiar, you figure these people never quit, but as somebody who has taken of about maybe 8,000 heroine and cocaine addicts, it's surprising how many heroine addicts clean up their act and some of them don't on methadone maintenance and go for long periods of time being productive working citizens. So, to understand the treatment outcome, you have to understand the different populations that are getting treatment, what you can expect from it, what your investment pays for, and what the outcomes are and I think we have more research on treatment outcome for alcohol and drugs than we do for a lot of other diseases. It's only that the burden of proof and I experienced this very much in working with trying to reform the health care system, the burden of proof is greater for those of us that work with addictions than for any other area. REP. FARR: First of all, I think it was Mark Twain that said, "giving up smoking is the easiest thing in the world", he had done it 1,000 times. But I guess my concern is that at some point -- I understand that treating addiction is to expect failure because people do fail and there are relapses and stuff, but there is some point where a person goes 100 times in the course of a year through de-tox, you begin to wonder whether there is a wise investment in your money for that particular individual. I know you can say, well maybe eventually you will turn around, but if it costs you a few thousand dollars -- DR. DAVID C. LEWIS: One hundred times -- we used to say, statistically, that it was the fifth or seventh admission in our hospital that got the heroine addict better. It more or less had to run its string. First (INAUDIBLE - MICROPHONE NOT ON) it wasn't 100 times, it was more like six or seven times for people that were the worst effected. The 100 times tends to produce a certain kind of revolving door and a special kind of cost and here in Connecticut and those of us in Rhode Island have solved this by longer term care facilities, different kinds of facilities than the more expensive hospital based treatment. So that's a very special population. It accounts for about two or three percent, at most, of the whole population and you match that kind of problem with a particular kind of health intervention, which involves fairly low cost, long term and you have that in Connecticut and Connecticut has some of the best programs in the country of that sort. REP. LAWLOR: Other questions? Representative Scalettar. REP. SCALETTAR: Thank you. Doctor Lewis, good afternoon. This morning an issue came up about prevention as opposed to treatment strategies and I was wondering if you have any experience in that and you could speak to what kind of prevention initiatives are successful with these populations? DR. DAVID C. LEWIS: Well, I think if we had to vote on what we would prefer to do, in terms of policy implementation, most of us would pick prevention. I mean, we would like to save everybody the trouble as an anti-crime measure, as an anti-addiction measure. So I think that is one thing we can all agree on. Then we come to a fundamental problem which has partly to do with the definition of what the problem is. If you say drug use is the problem, then prevention means no drug use in a drug free society. If you say drug harm is a problem, then prevention is intended to reduce harm. So it can deliver a clear abstinence message, but also, as I said before, try to say if you are going to use, use to do the less harm to yourself, the least harm to yourself and particularly, the least harm to others. So the fact of the matter is that drug education that simply says, "Just say No", when it's evaluated, doesn't seem to ring true with teenagers. I mean, there has been a major effort in the schools going in with a very hard policy line that says all or none. There is nothing in between. Just say no. Abstinence. Don't use drugs. You are talking to students that are drinking, that are smoking marijuana, and they don't believe the risks that are really there. So I think you have to say, okay, look -- some of you are going to use these drugs. We don't want you to use these drugs. We don't think any of you ought to use these drugs, but if you do use these drugs, this is what you have to know about these drugs. That becomes a more credible message. That's not the kind of message we are delivering and I think that's a mistake all the way across the board. Some idea and I use the drinking example -- if you say, don't drink and stop, if you go further -- if you say don't drink and stop, that's pure, that's okay. But if you say, don't drink, but if you do drink, for heaven sense, don't drive, that somehow saying that encourages people to drink. There is no evidence for that. So I think what you've got to realize in prevention, at least when it comes to education, that the message has to be realistic and it has to be true and communities have mobilized in a number of national projects to produce prevention efforts that have been extremely helpful because they have intervention and they have alternatives, particularly for kids that have time on their hands, for unemployed that need help in getting jobs. So that's another kind of prevention that is very important and a number of large scale projects have shown that this is effective. And we just haven't invested much in that kind. We have invested a lot of money, including recently, I think, $350 million in a campaign on television -- $175 million. A lot of money -- $175 million nationally for a public television campaign to increase the all or none message and I don't think that's where we ought to be putting our resources. REP. SCALETTAR: You mentioned that there are some communities that are doing more innovative and successful programs. Do you have examples of those? Can you tell us where they are, if not today, then just -- DR. DAVID C. LEWIS: Yes. As many of you know, Bridgeport was one of the community programs that was at the core of the Robert (INAUDIBLE) Johnson Fight Back Program and I think some of the communities that are involved in that Robert (INAUDIBLE) Johnson Fighting Back Program nationally and with the community coalitions that were sponsored by the Center for Substance Abuse Treatment, are very good examples and what I can do, rather than just name a few cities is I am on the National Advisory Committee for that Fighting Back Project. Why don't I send you, for the committee, a report, a recent report of the various communities and what they have done and that probably will answer your question better than my just tossing off a few names? REP. SCALETTAR: That would be helpful. Thank you very much. DR. DAVID C. LEWIS: Okay. REP. LAWLOR: Are there other questions? Senator Gunther. SEN. GUNTHER: You know, all morning I have heard about this being a health program and yet I think the least input that you get is with the health systems of our state, the data. We should have a total data bank and you people right now with the report that is coming out, wants to put it in OPM, the data on health care, as I understand it. Why isn't all the emphasis put into the health program for treating this disease and the effect it has on total health care in the State? We will never recognize that until we get a total health bank on health care. Now, do you have any feeling towards that? DR. DAVID C. LEWIS: Well, I think each state has their own data management systems. The really important thing is to recognize the relationship of these data banks and to have them kind of collaborate, if you will, with one another. So that you can see not only what the cost effectiveness is of interventions of the health system, but their effect on other social and community kinds of costs and that becomes pretty important. And then you understand why, for instance, providing certain critical social services along with health services are the way you want to go in terms of your budget. Otherwise you wouldn't see that if the social services budget are separate. And I used the example of the criminal justice budget or the justice budget and the health budget being totally separate. So it's not simply being able to use analysis on the health side, which is very desirable, particularly as managed care comes in and you want to see if their cost savings are just a hit and run one year operation, or long term, but you would want to actually build up a relationship among those data bases and that's very hard for both states and federal government to do. It's a tough call, but until we do that, we won't be able to see the relationships and what people really need until we do that kind of analysis. SEN. GUNTHER: But unfortunately, I think what is happening is just the opposite of what it should be. If you had a total health program, then you would have this data into a basic bank and then you could draw on that and the other fragmentations. We are fragmented all over a ten acre lot even when it comes to the education program and I've heard this comment. We have had education for how long under the Educational Department in this state to teach kids not to drink, not to use drugs. Teenage pregnancy. It don't work under the Education Department. It's a health issue. Maybe if the Health Department handled that and taught them the effect on their health, maybe we could get something in a basic data base. Have you any comment on that? DR. DAVID C. LEWIS: Not further than what I have already said. SEN. GUNTHER: Have you ever thought of that? DR. DAVID C. LEWIS: You are making my point, actually, better than I can make it. So I am not going to -- I am not going to interrupt you. SEN. GUNTHER: The only trouble is try to talk to -- in our process up here. We have people that want to put the health data base into the Insurance company or into the Insurance Commissioner, I am sorry, not the company. You know, you get all this fragmentation -- DR. DAVID C. LEWIS: The issue of private and public data become even stickier because they privacy concerns. So I am not going to -- this is such a treacherous area when you talk to what's proprietary information and what ought to be government information. The fact of the matter is, unless we figure out a way to do what you are talking about, to see what our real costs are, it's going to be very hard to do really sensible budgeting and everybody should be aware of the -- SEN. GUNTHER: When do we have the guts enough to say, look, let's get a total data base on health. You people are making the case for health and I will admit that I listened to my good friend, John Bailey there and he and I -- I think we do a little dancing around on that. I like John Bailey's approach because I think it's about time after listening to your speeches this morning that we realize that by having AR and have youthful offenders have a cop out on getting after the drug program, somebody up here ought to -- and I have to point to my lawyer friends here -- will maybe change the AR and the youth and when it comes to drugs and get down to brass tacks, do you think it will happen this year? John, you are nodding your head yes, but you mean no, don't you? JOHN BAILEY: My point is that it should happen. If we have these programs, there should not be a way to cop out. SEN. GUNTHER: I agree with you. Let's let the law side of it handle it. Let's have the health side take and do the data and the background, maybe we can get somewhere with it. Have I said enough? I get a cold breathe on my neck if it isn't Vinnie Chase. He tried to outweigh me. REP. LAWLOR: Senator Upson. SEN. UPSON: You stated that, for example, if you said something in school that if you drink, don't drive. What would you say if in front of students about marijuana use? DR. DAVID C. LEWIS: Don't use marijuana, but this is what you ought to know about the drug. SEN. UPSON: What would you -- go further. What would they have to know about it? DR. DAVID C. LEWIS: Don't drive. Same thing. What it does about coordination. I certainly wouldn't recommend -- if I am not recommending someone use it as a teenager, that's what I am recommending. If they do use it, I sure would tell them not to drive. I wouldn't tell them that it causes cancer. I wouldn't make things up. In other words, I would try to stick as close -- I would try to stick as close to what we know about the science as possible. SEN. UPSON: Okay. Thank you. SEN. GUNTHER: Could I make a -- SEN. UPSON: No. SEN. GUNTHER: -- quick follow up on a remark you made? It might be good to tell that it could produce cancer. I don't know if you have ever read, "Keep of the Grass" by Doctor Nahas, but he has done some documentation of stuff that's done for years and incidentally, there is a generic effect on the DNA by marijuana. They ought to know about these things and that's a health program and we get back to health. DR. DAVID C. LEWIS: But if the science isn't right, eventually people get very cynical about the propaganda. So the problem of saying that marijuana leads to cancer is two problems for teenagers. One, that's way down the pike and second, most people are occasionally users of marijuana and they are never going to use it enough to even dream of getting any kind of a cancer. So they know and they sense it's funny. The sense that it's coming from an authority, they begin not to trust the authority. I think we undermine our whole system when we kind of slap science in the face and make things up about drugs and portray them as a lot more dangerous than they really are by making up stories. There are plenty of dangers to drugs that are realistic and scientifically proven. We ought to stick to those. That's all I am saying. SEN. GUNTHER: Yes, but the same argument -- DR. DAVID C. LEWIS: Cancer isn't one of them with marijuana. SEN. GUNTHER: Mind you, we scream and yell about tobacco as a great cause for cancer and that, but everybody ignores the aromatic hydrocarbons that are coming from trillions of gallons of gasoline that are pumped out every day out on your roadways. And yet, that has no affect on cancer. Is one of the major carcinogenics. We ignore that. REP. LAWLOR: Further questions? Yes, Representative Dandrow. REP. DANDROW: Good afternoon and please excuse me not being able to make this morning's presentation. I did watch part of it on t.v. and I had another commitment. As the past co-chairman of Program Review, we did an intensive study on the State's substance abuse policies for juveniles and youth and there was a series of recommendations that was made within the report. Some of that really bothered me tremendously was that less than half of the young clients who complete the substance abuse treatment programs and not only that say half didn't complete them, but also 70% showed no improvement or even said some even got worse with respect to their drug use and addiction. Now, why would you think that would -- the addiction would worsen rather than become better after being even involved for a short time in a program? DR. DAVID C. LEWIS: Well, I am not sure the addiction is worse. I mean, adolescents are the tough part of this thing, it doesn't matter what we are talking about. We are talking about criminal justice programs. We are talking about treatment programs. We are talking about prevention programs. The fact of the matter is it is an unstable time and people are getting into what amounts to a natural history of up and down drug taking. Some of them are getting addicted, most of them are not. Some of them are into all kinds of other dysfunctional activities and many of them have seriously psychiatric (INAUDIBLE). So to focus just on the drug piece, is usually a mistake. You really have to understand the adolescent population you are talking about when you do these evaluations. There are many adolescent populations that are really disturbed and the drug thing is just a symptom of their disturbance. There are adolescent populations in which the only thing for them in their community, it seems, is the drug taking. There is no other activity. There is no other employment and they really get fowled up with that. So without knowing exactly what populations made up the data -- I wouldn't conclude until I know a lot more about it that the drugs cause the problem and that the intervention made it worse. I would want to know what other things were going on with those kids. That particularly true of adolescents. Less true with adults, by particularly true of adolescents. REP. DANDROW: Do you think that there is a tendency, a genetic tendency to use substance abuse if it's been in the family before or is it an inherited tendency? DR. DAVID C. LEWIS: I think the only information on inherited tendencies have to do with the likelihood of development dependence if your father and mother was also drug dependent. That's particularly true with alcohol where the most information is available like identical twins separated at birth and one placed in a family of drinkers and one not. They will tend to develop alcoholism based on their genetic parents and not in their foster placements. So we have a number of different kinds of data that indicate that the risk for developing alcoholism in children of alcoholics that drink, particularly alcoholic fathers is about five to six times greater than the general population. There is some information that some of that occurs on the drug side with heroine, but it's much less powerful than for alcohol. It hasn't been studied nearly as much. There seems to be a combination of genetic and environmental influences applied which is the case of almost of every one of the behavioral traits. Either it is over eating, or any of the things that you are familiar with that have a big behavioral counterpart. Environment plays a very, very big component even in those people that have a strong genetic influence. So environment, if you had to pick one or the other, is still the key even though a lot of this stuff seems to have a genetic vulnerability. REP. DANDROW: And if I can ask one more question. There seemed to be a tendency for substance abusing mothers, particularly, to drop out of programs and then they get their child back and go back home. Now meeting with a group of them, they absolutely positively assured me that even though there were using substance, they were able to care adequately for their children and their children were in wonderful, safe environments. I doubt seriously if you can be a substance abusing mother and adequately care safely and correctly for your child. Your comment. DR. DAVID C. LEWIS: Even if you can, I don't think that's the kind of way to go. I mean, basically, what are the alternatives for those women? I visited a program recently in Cleveland. It was very interesting. It was for women like that and the issue was when they got their children back and it really was a facility where they had intervention and treatment in a good day care center and they put the two together and the women did spectacularly well. So, the question is partly, are you leaving these people without help and just bargaining over the legalistic pros and cons of whether they get their kids back or do you have the programs available which might allow them and their children to benefit. So I have seen some very good programs in the area and that would be my first kind of line of defense. The theoretical issue, can you still be functioning well and taking drugs, particularly with alcohol, the most is known how many people in our society in big league responsible situations, function with alcohol with well known with marijuana. Even in the situation of heroine addiction and some cocaine addiction, if you know who the people are that are middle class and well jobbed and well situated in society that are using these drugs, it's pretty hard to demonetize the thing across the board. It's not a good argument for a mother and a child, but to say that all drug use has got to result in dysfunction, isn't what the science is about. However, the answer is to get the kind of treatment and intervention that works for the mother and the child and since you see good programs that do that, that would be my first of going about it. REP. DANDROW: I would appreciate it if you could send me any information you have on those programs. You could send them to the committee. Thanks you. DR. DAVID C. LEWIS: I will send it. REP. LAWLOR: Other questions? If not, thank you very much, Doctor. DR. DAVID C. LEWIS: Thank you. REP. LAWLOR: Next is Frank Hall from the Department of Corrections. FRANK HALL: I want to thank the members of the committee and the Chairman for this opportunity to speak. My name is Frank Hall and I am a District Program Manager with the Department of Correction, the Addiction Services Unit and I have about 24 years of experience in correctional substance abuse treatment and the reason I am here today is I sat in on the meeting this morning I wanted to emphasize the need for substance abuse treatment within the Department of Corrections. I see -- well I worked for the Department for almost 24 years and I see treatment within the Department of Correction as kind of the last resort of many of the inmates that we deal with. For the most part, people who have been through the treatment systems either on a pre-trial basis and were not able -- you know, for whatever reason did not complete the treatment program. These are people as Mr. Bailey alluded to who have committed more serious offenses and who do not qualify programs such as the Alternative Incarceration Program. As been discussed today, and I don't want to be too redundant, but addiction is a chronic relapsing disease and a major health problem. There are two factors -- two important factors that affect the outcome of the disease. One is denial. Basically most people who have an addiction don't accept or don't realize they have a problem. Also another factor is resistance to treatment. Many of the people who are abusers as a result of their denial are not interested into getting into treatment until they are forced to. Most cases it is either their family members, their job, or the criminal justice system that forces them to the realization that they have a problem and they need to do something about it. And I also want to point out that these factors are not unique to addiction. I am sure many of us know people who have suffered say, a heart attack who continue to smoke. They are denying they have a problem. They think they can continue to do what they did before and come out with the same results. I think it was kind of interesting on the presentation that Doctor Lewis made earlier and he had a series of questions about the drug war and one of the phrases or approaches that we use in drug treatment is we say to the client that if you expect to do what you have done before in the same way, and you expect different results, then you are really insane. So, in order to change your lifestyle, in order to become drug free and lead a productive lifestyle, a person has to change their feelings, the way they think and their behavior. It's a long process. It is not easy. Many of the people that we deal within a department of corrections have lengthy criminal and substance abuse histories, going back or 10 or 15 years. You can't expect that you put somebody in prison for two years and they have no treatment, you can't expect they are going to change their behavior. As has been pointed out earlier today, 80% of the inmates within the Department of Corrections are in need of substance abuse treatment. Unfortunately, -- well, treatment is not a priority within the Department of Corrections. Public safety and security are and I understand those important needs. Currently, less than 5% of the Department's budget is spent on substance abuse treatment. We, at any given time, are able to provide services to about 1,800 inmates in varying levels of treatment. And that's about 13% of the population that is in need of treatment. As has been documented this morning and this afternoon, substance abuse is highly correlated with criminal behavior, domestic violence, child abuse, HIV disease and other societal problems. One of the things about why I am here today is to emphasize the need for treatment within the Department of Corrections is that incarceration for all of its -- I guess, negative effects on a person's life, I think presents a unique situation for the individual to change their behavior. Usually people talk in treatment about hitting bottom. Usually, I think, most people would construe that once you are put in jail, you hit bottom. So for those people who have not been a minimal to treatment prior to be incarcerated, were able to provide an opportunity for these individuals to change their behavior. Now, fortunately as has been documented earlier, substance abuse treatment works. It's cost effective and it's critical to public safety. There was a report that was completed a couple of years ago by the California Health Department. They found for that every dollar invested in treatment saves $7 in other related health costs. Substance abuse treatment reduces criminal behavior. We have completed studies, outcome studies within the Department of Corrections, one in particular at the Women's Treatment Facility for a -- it's a long term six month treatment program for inmates who enter that program and completed it, the recidivism rate after 18 months was only about 27%. The recidivism rate for those inmates who were involved in no treatment was 70%. So the results are very clear. We have also done other outcome studies that have shown that other levels of treatment have also been effective at reducing criminal behavior. There is another study that should be out soon that continues to demonstrate that effectiveness. What I am asking is that treatment in Corrections, one, be given an opportunity and also that we strive to maintain, at a minimum, the current treatment services that are being provided. I realize that resources are scare within this state and there is a lot of competition from a variety of areas in terms of the various needs within this state that deal with the various ills of society that we deal with. And what I am asking is that substance abuse treatment within Corrections be given a consideration. Thank you very much. REP. LAWLOR: Are there questions? Representative Farr. REP. FARR: Good afternoon. On the treatment. What form of treatment do you give to -- FRANK HALL: Well, we have a variety of treatment interventions which we utilize and I will try to go over it very briefly. We have what we call a tier structure. There are four tiers. The first tier is basically just an intervention where we provide four to six sessions for mostly inmates who are at the direct admission facilities. The purpose of that is really just to explain them the consequences of substance abuse and provide information about programs within the Department of Correction. The next level of treatment we have is called Tier Two. That's where we -- it's an intensive out- patient program. Now when I say out-patient, that means the inmates live in general population and go to a central location to receive the treatment services. That program is basically provided two to three times a week in a group session and it is two to three months in length. The next level is Tier Three. It's is what we call day care program. It is four to six months in length. Persons involved in a treatment group on a daily basis. The last and most intensive and probably the most successful is what we call Tier Four. It is a residential program. Inmates are housed in a separate housing unit. There are currently six of those programs operating within the Department of Corrections. Inmates are involved at a full-time program for a period of six months. And so basically the treatment consists of skill development, teaching skill so they can live a more productive lifestyle, obviously more law abiding lifestyle, providing information about substance abuse, helping them to learn how to deal with particular problems that they encounter in life, and the general focus is individual and group counselling, primarily. REP. FARR: A couple of more questions about that. FRANK HALL: Sure. REP. FARR: Do you have -- do you use Methadone at all in the present -- FRANK HALL: Currently, the Department of Correction does not use Methadone maintenance. REP. FARR: And there has been proposals that -- to offer Methadone for patients. The clients are either short term or long term who are going to be leaving the system and the testimony the other day was that in New York they did that and 90% of the people who started taking the Methadone showed up at a Methadone clinics when they got out. And the Department hasn't -- is not doing that and doesn't have the assets, the funds to do that. Is that right? FRANK HALL: Well, let me express my own personal opinion regarding Methadone maintenance. I personally am going to have a problem providing Methadone maintenance within a correctional setting and part of the reason is that our current treatment system is based on the abstinence philosophy and that philosophy, basically, means that if you want to become drug free, then that means you can't use any drugs at all. So, providing Methadone maintenance is obviously contradictory to that philosophy. I think it would be difficult from a treatment perspective to provide a contradictory type of treatment approaches within a correctional setting. I certainly have no problem with Methadone maintenance in the community. And if there are individuals who are appropriate for that type of treatment, and want to become involved in it, upon their release to the community, then I think we can set up a system of assessing those individuals and making the appropriate referral. I think one of the other problems with the Methadone maintenance within a correctional setting is -- I know some of the proposals have to deal with people who are in a pre-trial basis. Well, obviously the problem is you don't know whether these individuals are going to be sentenced or released. If they are sentenced and they are placed on Methadone maintenance, then they would have to be taken off of Methadone maintenance. So I think there are some clearly some operational problems in terms of having Methadone maintenance within a correctional setting. REP. FARR: I guess the problem is that the program that was described in New York was one that if you get somebody on Methadone in prison where they have no alternative, that once they are on it, then there is a great incentive to go to the clinics once they get out. But if you tell them, well when you get out, walk out the door, there is the clinic -- next to the clinic is somebody selling or down the street is somebody selling heroin, you know, they are most used to heroin than they are the Methadone and they are going to -- they tend to go back to the heroin and they don't show up at the clinic. FRANK HALL: Let me also say that if the Department decided at this point their position is not to support Methadone maintenance, but I think this question probably could be better answered by the Director of Health Services because if it were to be administered, it would be -- since it has to be administered by physicians it would really be operated within that unit rather than the Addiction Services Unit. REP. FARR: Right. I have two other questions. FRANK HALL: Sure. REP. FARR: One is the drug use in the prison systems -- do you monitor -- do you do urine tests? FRANK HALL: Yes, within all of the drug treatment programs, we conduct urinalyses on a random basis. There is also, in all of the -- what we call Level Two facilities which are minimum security facilities, random drug testing is conducted. And there are consequences for use of the substance. There is a disciplinary process that would ensue if a person was found to be using substance. Let me say, in addition to that, also the Department uses dogs who come in and do -- they use dogs for searching inmate cells. REP. FARR: A quick question for you, though. Percentage of people that show up having used drugs in the prison -- do the random checks, what kind of percent do you show that come up showing that they have used drugs? FRANK HALL: That are positive? REP. FARR: Yes. FRANK HALL: I am not -- I don't really have access to those particular statistics. I don't know if I can really help you on that. I can say that in the past when -- REP. FARR: Let me just ask you -- we have to kind of cut it short. If somebody could get me the data, I would like to see some data on that so that I have an understanding how frequently drugs are used there. Also, if you could later supply me with some data as to the cost of the various drug programs you are now doing, if you have that. FRANK HALL: Sure. REP. FARR: Okay. Thank you. FRANK HALL: I will be glad to provide that part. REP. LAWLOR: Thank you very much. FRANK HALL: Thank you very much. REP. LAWLOR: Oops. REP. DANDROW: Yes. Just one quick question. All of the programs that you have described, they are available to women at the Niantic -- FRANK HALL: Yes. Basically at -- well now they don't call it Niantic anymore. REP. DANDROW: Right. FRANK HALL: It is called the York Correctional Institution. There are basically two correctional facilities located there. York is the maximum security and what they call York East now is the minimum security. There is a Tier Four program at York East and there is a Tier Two Program at both facilities and there is also a Tier One at the York Maximum Security. So there is basically three levels of treatment programs that are available for the women. REP. DANDROW: And there is an adequate number of women enrolled? FRANK HALL: Their programs are all full. REP. DANDROW: They are all filled. FRANK HALL: Almost all of our programs are at 100% capacity. In fact, there is -- you know, the waiting lists are quite lengthy for -- REP. DANDROW: That was my next question. Is there a waiting list? FRANK HALL: There are waiting lists for all the programs. The other thing I wanted to comment on, I know there was a comment earlier about -- I believe Representative Farr mentioned about the completion rate. And I would say that within the Department of Corrections, the completion rate for most of our programs is over 60% and I think part of the reason is that involvement in the treatment program is often somewhat of a pre-condition for release to the community. If you complete a program you are going to be in a better situation in terms of an inmate being released to the community. So there is an incentive, obviously, to complete the program and make yourself, as an individual, more eligible for release to the community. REP. DANDROW: Thank you very much. FRANK HALL: Thank you. REP. LAWLOR: Thank you. If there is nothing else, thank you very much. We are trying to accommodate the members of the public and some of our invited guests so we are going to alternate back and forth between the two lists in an effort to get through in a timely fashion. So, going for once to the public list it will be Yolanda Redin and she will be followed by Susan Patrick, who I know is accompanied by some other individuals. Yolanda Redin. YOLANDA REDIN: Hello. I thank you for letting me talk. I am a recovering addict myself. I have been through the system. I was a prostitute. I do have AIDS. It took me until I was in my 30's until I even started drugs, I had any kind of a record at all. As far as the prison, yes, Niantic does have Methadone treatment -- six days they de-tox you starting at 25 milligrams and I don't know if any of you can understand the de-tox or know how it feels, but unless you have been through it, it's the worse picture of the worst type of flu you ever had, like the sweats and the diarrhea and the throwing up and stuff like that. And when you are picked up you are put into a cell, okay. Say if it is a long holiday weekend -- I've been picked up on a Friday. I have seizures when I go through withdrawal, brought to the hospital, given seizure medication, but nothing for withdrawal and have to spend Friday, Saturday, Sunday, Monday. So by the time I go to Niantic on Tuesday, it doesn't show it in my urine so they don't want to give me Methadone. I don't think they should de-tox they way they do. I think they should continue people on the Methadone at one rate. I feel that no matter -- for me, it was like in and out of jail -- in and out of jail because I went in jail, did my few months, came back out and the urge is always in you. You know, you -- basically all the girls that I have known, their thing is to come out and get high again. And that's where I was until I hit dirt bottom. I got PCP pneumonia and I was admitted in the hospital like seventeen times. I wasn't out more than 10 days and I would be back admitted to the hospital. I've been in the Methadone program. I have been three years clean. I do believe that they should open up and have easy access because I have read some percentages of people who do get on Methadone treatment which it shouldn't be at my -- when I was out, it was a nine month waiting list. So by the time you got to the top, you were already in jail. You know what I am saying? But now it's down to two weeks or three weeks and it shouldn't even be that. It should be immediate if you want the Methadone, you should be able to take it. They say over 80% that get off the Methadone go back to drugs, you know. I know for myself, it shows in my record I have been clean all these years. I found a good man. Doesn't have AIDS. Got a beautiful home in Windsor Locks and I am living with him now. I think it's unfair the way they put you in the jail and let you de-tox like an animal. If you call for a sheriff they tell you to shut the hell up. I think somehow they should be able to give them Methadone while they are sitting in the cell, especially on a long weekend. I don't think they should de-tox you within six days. I ended up with 104 fever trying to de-tox. The doctor came into my room once. They kept me in ice-packs, okay. I seen a girl die because it was time for lock-up and nobody came to open the door. We were banging and they threatened to give us extra time lock-up. The girl died in the shower with vomit all on herself. It was an hour before they found her. I seen a girl choke on ice, okay, before she got a Methadone and she choked to death between the vomit and that. I just feel there are a lot of things unfair. When you have AIDS even now, I mean, if I say I have AIDS, the gloves come on up to here and you know and just put the mask on. You cannot catch it unless I have an open cut bleeding and you've got an open cut or with sexual ways you can catch it. Unfortunately, people are ignorant. A lot of people are ignorant to the fact of AIDS. I don't know. It is rough out there in those streets. It is basic survival and for me it was in and out. I did that program he was talking about in Niantic. Within a couple of weeks they threw me out because I had an argument with a girl, okay. It wasn't helping me anyway. There were drugs brought in. I got high while I was in there. A girl went out on a weekend and came back with some coke and dope. I was in lock-up. The dope was brought right through, okay. You know, and the way it is done is they bring it up through whatever way they have to which is really kind of dirty, but if you want to get high, you don't care. Do you know what I am saying? The cops talk down to you. There was a cop out there at one time. He would just stop you to disgrace you, call you all kinds of names. Tell you to not breathe on him. He doesn't want any of your germs of you know, the guards. There are guards that actually get drugs for you if you do something for them, you know, things like that and all that would be unnecessary if they would just look more into the Methadone program and how it works for people. I know it has done wonders for me. REP. LAWLOR: Yolanda, how long has it been since you've been out of Niantic? YOLANDA REDIN: Over three years. Since I have gotten clean on the Methadone program. Deborah who is with me, she was 17 years out in the streets in New York and in Hartford. Once I got clean I knew her and the bum she was with who was taking half her stuff and I basically got her out of the shooting gallery and she has been clean for a couple of years now. REP. LAWLOR: That's great. YOLANDA REDIN: And you talk about 17 years of drug use. Okay. She is on Methadone. She's got take homes like I do. I've got five take homes from staying clean. I am also on 300 milligrams of morphine a day because of the AIDS and my hepatitis in my liver. Clonapin. It doesn't phase me. I used it -- what is that -- three bundles I have it. I couldn't get out of bed unless my works and stuff were ready. REP. LAWLOR: And where do you live and where do you have to go to get your medication? YOLANDA REDIN: Obviously, you work the streets in Hartford. When they did that five day spread in the Hartford Court -- REP. LAWLOR: Yes. YOLANDA REDIN: -- I agreed to show Mary Otto around Hartford. I introduced her to girls only because it was told to me that they were going to open a house for the girls where they would have a place to sleep, rest their head, get a meal because you would go days -- I used to be like 110 pounds when I was out there. Get a meal. Get some advice about AIDS. REP. LAWLOR: What about now? Are you getting medication now or Methadone or anything like that? YOLANDA REDIN: I am on a Methadone program. REP. LAWLOR: And where do you go to get that? YOLANDA REDIN: I go on 345 Main Street. REP. LAWLOR: In Hartford? YOLANDA REDIN: In Hartford. REP. LAWLOR: And you live in Hartford? YOLANDA REDIN: No. I live in Windsor Locks. REP. LAWLOR: Windsor Locks. Okay. YOLANDA REDIN: Yes. REP. LAWLOR: So how do you get back and forth? Do you drive? YOLANDA REDIN: No. I get a cab. REP. LAWLOR: Every day? YOLANDA REDIN: Yes. Well, I get five take homes. REP. LAWLOR: I see. I see. Okay. YOLANDA REDIN: Take home bottles which -- REP. LAWLOR: Does anyone else have any questions? Representative Winkler. REP. WINKLER: Thank you, Mr. Chairman and thank you for coming before us and sharing your story. I think you are doing very well. YOLANDA REDIN: Thank you. REP. WINKLER:You mentioned that going -- when they locked you up when you going through withdrawal, that they didn't give you anything -- YOLANDA REDIN: They won't. Nobody. REP. WINKLER: -- because that nothing showed up in the urine? YOLANDA REDIN: Oh, that's once I got into Niantic even after being -- it was a long holiday weekend, okay. I got picked up because I was in the guy's car. Detective Hawkins seen me. He was always behind me. But anyway, they followed the car, pulled us over and -- I mean you would get arrested -- I got arrested one time for sitting down. I was eating some cookies, drinking milk. Get arrested for disorderly conduct with intent of prostitution. Okay. They could pick you up just because you are sitting there. Any reason. Or the cops -- if you read every description of the busts they give, every one reads the same. No girl walks up to a car and propositions herself. The cop propositions the girl, you know and then they turn it around to their liking and put it the way they want. But yes, I was -- by the time I got there my urine showed up clean because I had already spent Friday, Saturday, Sunday, Monday. By the fifth day it doesn't show in your urine. REP. WINKLER: What drug were you on at that time? YOLANDA REDIN: I was a three bundle a day user and cocaine, at least a 16 eight ball a day heroin. REP. WINKLER: Because that won't -- that would still show up in your urine even after five days. YOLANDA REDIN: No, it doesn't. No, it won't. I am sorry, Ma'am. I hate to disagree with you, but it doesn't. After four days it shows up clean. REP. WINKLER: That's not what we have heard. YOLANDA REDIN: Well, I am telling you the truth. I hear somebody else speaking that agrees with me. Seventy-two hours it is out of your urine. UNIDENTIFIED SPEAKER FROM AUDIENCE: Yes. Seventy-two hours. YOLANDA REDIN: See. Thank you. I would love for anybody else to ask me anything they would like. REP. LAWLOR: Well, if there is no other questions -- oh. sorry. Senator Harp. SEN. HARP: I am just wondering if you can tell me how frequent it is that people get sick or even die because of the way -- of the de-tox that we use in our correction system. YOLANDA REDIN: First of all, when you go in, I mean what they give you is a joke. For somebody like me with the addiction that I had, okay -- from the time I was 12 I was put into the institute and put on Thorazine. I mean, all my life I was drugged up because I was a ward of the State, but I managed to stay. I got married early. I managed to raise my children. I managed to stay with a man and before I knew it, I just ended up into drugs after I lost him and it just -- you can't say that it will never happen to you because it can happen to anybody, okay. Again, I am sorry -- ask me -- SEN. HARP: I guess what I was saying is how often is there an negative reaction to the type of de-tox that we do? YOLANDA REDIN: They give you so little. Okay. They give you like 20 milligrams to 25 and they de-tox you in six days. So, any time I was there I would spend a month in the medical unit because I would go through seizures. I would get fevers. They don't -- I mean with 104 fever, as sick as I was, especially being HIV, you would have thought they would put me in the hospital. The doctor came into my room once. The third day of my fever they took three nurses to hold me up. They said I had to walk down the hall in order to get my Methadone. I threw it up all over the ground. It was so useless. If it wasn't for a girl who took a chance and stayed in the room with me to keep an eye on me, I was dragging myself back and forth to the bathroom, didn't eat nothing all week and so they brought -- not a real doctor into see me, you know. I didn't consider him a real doctor anyway. And I think that -- I don't know. I think Methadone -- if people who come out -- any girls that have come out back to the streets, they have nothing, okay. I don't have any family that accepts me now, especially because I am sick. So they drop you off at Lafayette Street. They give you no sense of -- no sense of good feelings or anything. You don't get really any counselling in jail. So you come back to the streets and dropped off at Lafayette and it's back to Washington and Broad, out to make money because you are thinking about them drugs all the time you are in jail. Where if I had the Methadone opened to me a long time ago, I don't think I'd be as sick as I am now. And I don't think you should have to suffer in a cell, you know. We are not animals. We may be messed up our lives somewhat, but it doesn't make us any less of a human. SEN. HARP: Thank you. YOLANDA REDIN: You are welcome. REP. LAWLOR: Thank you very much, Yolanda. YOLANDA REDIN: Thank you. REP. LAWLOR: Next is Susan Patrick. SUSAN PATRICK: Thank you. Yolanda's life is what gets me up in the morning, determined to prevent this problem from ever happening. I want to thank you for the opportunity to participate in this hearing today. My name is Susan Patrick and I am the President of Drugs Don't Work which is the Governor's partnership for Connecticut's workforce. This organization was created in 1989 as a public/private partnership between the State and the private sector with the goal of levering private sector money towards solving the problem, which we do by matching the State's investment in the program. We were given the charge to lead the State's prevention effort, to reduce substance abuse, and we do this through four operating partnerships that work with 140 school districts, all the State's colleges, about 2,400 businesses and 70 media outlets that donate about $1 million a year of anti-drug advertising. I was also a member of the Alcohol and Drug Policy Council and Co-chair of the Youth and Families Committee. I would like to introduce the two young women who are with me today that will be speaking with me. Laura Baum is a senior at North Haven High School and a member of the Drugs Don't Work Youth Advisory Committee and Dana Sanetti to my immediate right, is a sophomore at Bunnell High School in Stratford and also a member of the Youth Advisory Committee. We are here today because we care deeply about the affects on drug use on young people and the citizens of Connecticut. I would like to particularly focus my remarks on the issue of prevention and on the problem as it relates to young people. I would like to offer some general observations in relationship to the three reports that have come before the two committees. The reports taken together represent an extraordinary analysis of the State's current substance abuse policies and opportunities. David Biklen, in particular, has created a report that will be used as a reference tool in the field for years to come. One of the things that was most striking to me, however, was the assumption that the current drug policy is not effective. As you heard earlier, drug use has come down by about 50% and is staying down in adults. Teen abstinent rates actually increased, doubled from 7% to 14% during the period 1979 to the early 90's. Most of this reduction probably can be attributed to increased funding for prevention and law enforcement that took place during this period. In spite of these successes, the recent increases in teen drug use and the escalating costs of the criminal justice system are good reasons to stop and look at our drug policy. I am encouraging you and us not to take too narrow a view of the State's drug policy issues. It's important to consider all the harms and costs associated with these issues. Health care costs, for example, which are driven primarily by tobacco and alcohol use are legal drugs will exceed $1 trillion over the next 20 years. In Medicare alone, substance abuse associated hospitalization costs top $20 billion in 1994. They account for about 25% of our total expenditure of Medicare, of the Medicare fund. While criminal justice costs might be reduced by new policies that would lower the penalties for the possession of marijuana, we should also consider how these policies might drive up health care costs. Among youth age 12 to 17, marijuana related medical emergencies have more than tripled in the last five years. Further, we have yet to experience the longer term health affects of marijuana. It's estimated by some researchers that each marijuana joint is as carcinogenic as ten to twenty cigarettes and I mentioned earlier that cigarette smoking is probably the biggest drain on the Medicare trust fund. We also have to consider the cost of substance abuse in relationship to our work force. How much will business loses increase if marijuana use becomes even more wide spread than it is now? Seventy-five percent of substance abusers are currently employed and substance abuse costs America's businesses close to $100 billion annually. It is interesting to note that the drug most associated with crime and with violent crime is actually the legal drug, alcohol. Thirty-nine percent of violent crimes, the ones most feared by the public, the ones that call for your responses, are committed under the influence of alcohol compared to 24% committed under the influence of illegal drugs. Alcohol is implicated in 18% of murders, 15% of rapes, 17% of assaults and 15% of robberies, resulting in 400 deaths and over a million, almost two million crime victims each year. Given that the three reports find room for significant improvement in current policy, we must carefully consider what policy options will return the highest value for the State's investment. While there are many excellent recommendations contained in the reports, I was distressed that while all three reports called for a shift in policy towards public health and prevention, education, and treatment, only the alcohol and drug policy council report contained substantive recommendations related to prevention. In some ways, prevention was as overlooked in the reports as it has been in the State's policy during the 17 years that I have been working in the State. It is very disturbing because prevention is the most cost effective approach of all returning $14 to $15 for each dollar invested. This is double the return of the $7 for each dollar invested of treatment. It is estimated that we will save between $300,000 - $800,000 over the lifetime for each young person that we keep from using drugs. In spite of this cost effectiveness ratio, substance abuse prevention spending across all agencies as detailed in the prevention budget, totalled only $10 million. This compares to a Corrections budget of over $300 million. As you can see from the charts -- REP. LAWLOR: Four hundred million. SUSAN PATRICK: Oh, it's gone up since then. Right. As you can see from the charts I provided in the information packages there is a direct correlation between the rates of teen drug use and juvenile drug offenses and the level of spending on prevention. The increasing transit in teen drug use as I mentioned, in eight grade marijuana use, for an example, is tripled, occurred immediately after federal and state prevention funds were cut in the early 1990's. I my own organization, our funding fell by 75% in just three years as a result of cuts in the safe and drug free schools acts, schools laid off health educators. They laid off substance abuse counselors. And so we are seeing that wave of young people who did not receive the intensive kinds of prevention programs that we had early in the 80's. Not only is prevention the most cost effective approach, it is also the approach most supported by the public. In a 1995 Gallup Poll prevention received twice as much support as criminal justice as the preferred public policy option and ten times as much support as treatment, in terms of long term solutions. And the end of my remarks I will make a couple of recommendations for things I think we can do to increase this emphasis on prevention. But before I do that I want us to just also consider the unanticipated and unintended consequences of some of our drug policies. As you will hear from Laura and Dana in a minute, recommendations to reduce penalties for marijuana and to prescribe marijuana for medical purposes have a profound effect on young people contributing to a growing belief that marijuana is a harmless drug. The Program Review and Investigations Committee report points to increasing social acceptance, easy availability, decreased costs, and increased strength as key factors in the marijuana use increase among our young people. If our lack of success in keeping cigarettes and alcohol out of the hands of our youth is any indicator, I think it is pretty reasonable to assume that if marijuana is grown legally by adults for medical reasons, it will make its way into the hands of kids. While I don't have time today to review the facts about the harms associated with marijuana, I've provided that information in your packets. At the same time that the harms of marijuana have been documented in over 10,000 studies, there is not one reliable study that proves that marijuana is the most effectatious medical treatment for the conditions for which it is being considered. Now I am not saying that marijuana has no medical use at all. What I would suggest though is that even if there is medical value in marijuana, is it worth the price? Is it worth the price of a generation of young people who see it as a harmless drug? Already one in twenty high school seniors are smoking pot on a daily basis. Kids who smoke pot are eighty-five times more likely to use cocaine. By fiscal year 1993, the percent of teens in treatment from marijuana surpassed those involved with alcohol and marijuana was the most frequently used illegal drug by juvenile arrestees. In light of all this, I would like to make the following recommendations. New prevention policy options, soundly grounded in research, must be developed. The recommendations that are in some of the reports are a good start. We need a total overhaul of the school drug prevention programs. Many of them are outdated. They are inconsistently implemented and they are not responsive in many cases to the needs of young people. While schools cannot solely be held accountable for solving the teen drug problem, as we have asked them to be in the past, they can and must be held accountable for identifying and intervening with kids who use at school. Five percent of junior high students and eleven percent of high school students say they use drugs at school, during the day, on school property. Eight percent of junior high students and seventeen percent of high school students say they attend classes under the influence of drugs. The generational -- another recommendation is that we must interrupt the generational cycle of addiction by targeting intensive prevention services to those youth who are at the highest risk by virtue of a parent who is incarcerated in a treatment or abusive. As you all know, these problems repeat themselves from one generation to the next. We have the opportunity by targeting prevention services to those kids whose parents are already in our system so we can easily identify them of interrupting that generational repetition. We also need earlier identification and intervention with youth. The longer the problem is allowed to progress, as you know, the more expensive and difficult it is to treat. One dilemma is that health care currently does not cover these intervention services, however. The vast majority of juveniles and adults who are currently in our criminal justice and treatment systems, used drugs for many years before arrest and for the most part, began as teenagers. If thirteen percent of Connecticut's 7th graders and twenty-eight percent of our 11th graders are getting drunk on a weekly basis, why aren't the adults seeing it and doing something about it? How have we allowed things to progress to the point that one in twenty high school seniors is using pot on a daily basis? That's harmful use by any definition. Parents, school personnel, and youth workers must be trained to recognize these warning signs and take appropriate actions. Physicians and health care providers must be trained. REP. LAWLOR: Susan, -- there are a lot of people signed up to testify. SUSAN PATRICK: Okay. REP. LAWLOR: So we have to get to the students and to the other people. SUSAN PATRICK: Okay. Because of these factors for drug use another recommendation is because the risk factors for drug risk are the same as those for delinquency and for other teen problems like pregnancy, teen pregnancy, youth violence, truancy and dropping out of school, we lose a really incredible opportunity for maximum prevention efficiency by not integrating these programs and having commonly defined outcomes. Finally, we need to try new research based approaches like mentoring, peer taught drug education and parent involvement. I would also like to suggest that you consider requiring that prevention services be incorporated into state managed care contracts that we create and test case management and intervention models that link schools, community agencies, and the police and that we test public health based environmental approaches to reducing use of the legal drugs among young people. I will cut my remarks at this point so that we will have time to hear from Laura and then Dana. Thanks. Will she be able to be heard from this microphone? REP. LAWLOR: Yes. LAURA BAUM: Okay. Thanks. My name is Laura Baum and I have been an active member of the Drugs Don't Work Youth Advisory Committee for two years. I am here to talk about the drug use that is becoming so prevalent among my peers. I could stand here and tell you that drug use among 8th graders alone has more than tripled in the last five years. I could tell you that one in four children betweens the ages of 9 and 12 was offered drugs in 1996. I can tell you that 68% of 17 year olds can buy marijuana in less than a day. However, I am not going to continue to list statistics. Instead, I am going to talk about some of the issues and concerns that young people face relating to drugs and about some of their recommendations in solving this problem that affects their lives and the lives of their peers. On May 22, 1996 the Governor's Youth Summit on Drugs was held at Trinity College. One hundred and thirty-six youths and thirty-nine adults from 47 schools and 31 towns gathered to discuss teen drug use. The participants had small discussion groups facilitated by youth in which they discussed their concerns and recommendations for actions. The young people shared their concerns about increased drug use by youth, early initiation of drug use by younger students, the need for increased prevention and intervention, adults ignoring the drug crisis, and not taking it seriously enough, adults, schools, and communities not consistently enforcing drug policy and laws, and punishment not being enough to solve drug abuse - that drug abusers need help and support to change their behavior. Young people recognize that parents are not always supportive and proper role models for their children. Parents may feel that they have provided information about the dangers of drug use, when they have not. Parents may also not realize how available drugs are. Only 7% of parents believe that their children have been offered drugs, but 24% of children report being offered illicit substances. Some parents do not realize what an affect they have as role models of their children. Thus, the young people of the summit felt it necessary to educate parents to talk to their kids earlier, more frequently, and more seriously in addition to telling them to model healthy behaviors. The young people also expressed concern about schools handling the drug problem. They want schools to take the drug problem more seriously and to enforce drug policies consistently when young people use drugs. Inconsistent enforcement gives mixed messages to students, parents and the community. A recommendation for the community included increased enforcement laws and increased penalties for drug violators. The young people then noted that laws that aren't enforced give youth mixed messages. They also felt that there should be more drug free alternatives for youth. The young people also said at the summit, that we, as youth, need a more active say, a full voice in helping to solve the drug problem. Parents, the community, the government, and the media need to come together with youth to target this drug problem. A main contributing factor in the increased drug abuse by young people is that many of them do not realize the dangers of a drug like marijuana. There is less social disapproval of drugs as children are less likely to believe that people are on drugs are affected and act in stupid ways. Also, many young people have recognized a growing and unfortunate tolerance for drugs in society. Another factor that leads to an increase in drug use is that children are receiving less information about the dangers of drugs from a variety of different sources, particularly in the mass media. When children were asked if they learned a lot about the dangers of drugs from t.v. shows, news and movies, only 44% responded yes in 1996 compared to 53% in 1993. The bottom line is that we cannot send mixed and confusing messages to our young. We must show them that drugs are dangerous and that there are severe consequences for people who abuse drugs. There are 68 million people age 18 and below. If we pretend that pot is just another insignificant choice in their lives, we make their decision to stay off drugs that much harder. It should be apparent to young people that there are ramifications for the illicit use of drugs. Other young people have called upon policy makers to make their schools and neighborhoods safer, to rid them of drug offenders. We cannot let our young people continue to abuse drugs anymore. Students may get the incorrect impression that a drug like marijuana isn't dangerous, but then they succumb to the dangers of the drug and perhaps other drugs like heroin and cocaine since marijuana is a gate (INAUDIBLE) drug. We cannot continue to let our youth believe this. They must be told and reminded that drugs are dangerous to us. Thank you. REP. LAWLOR: Where do you go to school? LAURA BAUM: North Haven High School. REP. LAWLOR: And where do kids buy drugs at North Haven High School? LAURA BAUM: I think that drugs are easily accessible from the peers within the school. That is really easy to just go up to someone in the hall and get drugs. REP. LAWLOR: And do you know what the penalties are for possessing drugs in Connecticut? LAURA BAUM: I don't know exactly. REP. LAWLOR: Take a guess. What do you think -- LAURA BAUM: I really don't feel like I have the -- REP. LAWLOR: Because I was asking because you mentioned a couple of times that the penalties aren't high enough and stuff like that. LAURA BAUM: Well, I mean, I think that the bigger issue with the penalties -- a big issue with the penalties is that they are not enforced and that kids -- my peers don't realize that they are enforced even if they are. REP. LAWLOR: Have any friends of yours ever gotten arrested for selling or having drugs or anything like that? LAURA BAUM: Of course. REP. LAWLOR: And what happened to them? LAURA BAUM: I've seen them in school. REP. LAWLOR: But what do you think should happen to them? LAURA BAUM: I think that they should have penalties, whether -- REP. LAWLOR: Like what? LAURA BAUM: Like perhaps fines and jail and then prevention afterwards so that it doesn't continue in a bad cycle. REP. LAWLOR: Okay. I'm sorry. There might be some other questions here. Yes. DANA SANETTI: My name is Dana Sanetti. I am 16 years old. I am a sophomore at Bunnell High School in Stratford. This is my first year in Drugs Don't Work Youth Advisory Committee. I think that it's important to treat substance abuse, but preventing kids from even starting is the like the most important. A big -- my big thing is that parent/child communication needs to be enforced. Parents need to talk to their kids about drugs. They need to be informed. They need to know what's going on. Only 40% of the parents think they have no influence on their child's drug decision. That's - - they have to know what they are talking about and they have to talk to their kids frequently. Ninety-five percent of parents said they have had a serious talk with their kids, but only 77% of teens say that -- agree and remember the talk. It can't just be once. It has to be over and it has to be frequent and it has to be a serious thing and it has to be something that parents and kids feel they can talk about openly. Education, I think, needs to start very early and it has to continue on through high school. Drug use can begin sometimes as early as 6th or 7th grade. To me, that's pretty scary. In 5th grade we had the D.A.R.E. Program and that seemed to work pretty well, but then in junior high, I couldn't even tell you where my health class was or who taught it. I mean, I don't -- let alone what I learned. There needs -- something needs to be looked at there. It's -- in high school we only have a health class in freshman and senior year and there is an adult standing up in front of the class and preaching to us about the affects. I think something that would help would be to have a senior or a junior maybe teach a class to the freshmen or sophomores. When kids talk to kids it seems more real and it doesn't seem as though they are preaching. Kids need to learn the effects of drugs, but also how to cope with these situations and how to cope with the pressure. Kids can know all the affects and everything that it will do to them, but unless they know what to do in those situations, it's not going to work. I mean if a friend offers you something, if they are a good friend, then you are probably going to take it regardless of what you've been taught. They need to know what to do and how to cope with those kinds of situations. As I said, I think kids teaching kids is a very good idea. Early teens, I think, is when we realize that we can -- even if authority figures say that we shouldn't do something we can still kind of do it and usually get away with it without punishment. So -- I mean something -- we need to have not like an adult telling us what to do, a kid is - it just sounds more real when it's coming from another kid. We kind of like listen to our own kind, I guess. When the laws and consequences in my school -- I mean, I don't -- the people that I hang out with are not involved with drugs, and I don't even know what happens. I don't even know what the consequences are, which to me shows you that it's not something -- I mean, I don't know about it. I don't know what happens so I think it needs to be enforced and people need to know what happens to you if you get caught. I know that I've seen -- you can get illegal drugs in my school, but I don't think enough is being done about it. I don't think the kids know what can happen to them. I think it needs to be enforced more. It needs to be more strict. REP. SCALETTAR: Can I ask you a question? As you are discussing that, what about tobacco? Is that a problem in your school? Do you see kids smoking outside or in school? DANA SANETTI: Kids -- there are always kids smoking outside before and after school. And in the bathrooms during school it happens, not as much as before and after, though. REP. SCALETTAR: But you think a lot of kids are smoking? DANA SANETTI: Yes. There is like little spots where everybody goes. During school I think it's not as much of a problem, but it is there and I mean -- I don't know what happens to kids when they get caught smoking on school grounds during the school hours. I think that -- REP. SCALETTAR: Why do you think they are smoking? DANA SANETTI: Why? REP. SCALETTAR: Haven't you had a lot of programs in education in school about the dangers of tobacco? I would think people your age have heard this quite a few times. DANA SANETTI: We know the effects and we know what it does to you, but once -- I think once you start, the effects don't matter anymore. It doesn't matter -- you know it's not going to happen to me is what everybody thinks. REP. SCALETTAR: Thank you. DANA SANETTI: I think the laws can't be -- if the laws are not --- don't become as strict -- if they even like ease up on the laws, more kids are going to just think of marijuana as a harmless drug and that's not what it is at all and that's not the image that I think marijuana should project. If they see more people getting into trouble for it, then that kind of image will stick in the minds like if they actually see it happening, actually seeing the consequences that would help, but I don't think they ever do. REP. LAWLOR: Senator Harp and then Senator Gunther. Representative Nardello. SEN. HARP: I just wanted to ask you, as well, if the kids in your school deal the drugs in school so that anyone can come up in your school and purchase drugs right there as with the young lady at North Haven High School? DANA SANETTI: Like if I went up to somebody and asked if I could get it right there on the spot? SEN. HARP: Yeah. Are there people that deal drugs inside the school building? Or do they have -- where do the kids go to get the drugs in your school, I guess is the question I am asking? DANA SANETTI: It happens more outside of school than inside the school. I think I wouldn't -- I don't think I would be able to go up to somebody and just ask and be able to get it right there on the spot, but I have seen -- I think it's like more or a pre-arranged kind of thing and they just kind of get it in school. It's not something that -- it's not a big issue in my school. I mean, I've seen it once or twice. SEN. HARP: Have you seen more people smoking cigarettes before and after school than you have actually seen using drugs in your school? I am just curious? DANA SANETTI: Yes. More people smoke than -- I mean, I don't normally see people using drugs in my school. Just is it when people are smoking before and after school, it's just right there in your face. You can't miss it. SEN. HARP: And your knowing about the level of substance abuse in your school is based upon personal knowledge or statistics that you've heard from the leadership in your school or that your school district or from your participation on the council that you sit on? DANA SANETTI: It's mostly personal knowledge and information that I get from this council. SEN. HARP: And how many -- but you don't know anybody who actually does it in school is what I thought I heard you say. So what percentage of people would you guess are doing it in your school? DANA SANETTI: In my school? Like during school hours, people that are using -- I don't know, five to ten percent. It's not a big percentage. SEN. HARP: Do you know kids in your school who are drinking alcohol? DANA SANETTI: Yes. SEN. HARP: And what percent would those be, do you think? DANA SANETTI: Oh, over 50%. SEN. HARP: Over 50%? DANA SANETTI: Yeah. I would say 60 or 65 percent. SEN. HARP: Okay. Thank you. SEN. GUNTHER: You mentioned that you didn't know when your classes were on the drug abuse and that. They don't put notices up on the board as to when your class -- you mentioned you didn't know when your classes in drug -- in substance abuse were. DANA SANETTI: Oh, in junior high school we had a health class for a half a year. Those classes -- I mean, I don't remember anything about those classes. I don't remember learning anything. I don't remember where they were, who taught them -- I mean, my point being it didn't have a great impact on me at all and that -- I mean, I think it should. SEN. GUNTHER: You don't remember who taught it? It wasn't the nurse? It was another teacher? You have no recollection? DANA SANETTI: I really don't. SEN. GUNTHER: How about now in high school, are you getting any specific training? DANA SANETTI: As I said, I am a sophomore. We only have a health class freshman and senior years. So right now, I don't have any kind of -- SEN. GUNTHER: So you have no class at all? Nobody is teaching you anything about what's going on in the real world out there? DANA SANETTI: Only freshmen and senior year. SEN. GUNTHER: There is no real program -- I see you looking -- are you surprised at this, by any chance or -- SUSAN PATRICK: I would just like to comment on that actually. I think one of the things that happened a couple of years ago was that the statutes were changed so that the State Department of Education no longer went out and did compliance to assure that schools were teaching. I also want to say though that the current statutes that require that we teach kids drug education every grade level may not be the best approach. There was a famous quote that is one of my favorite quotes that says that education is the cure only insofar as ignorance is the disease. And these kids know the affects of drugs by the time they are in late elementary school. I think what we need is a different approach which is why we are recommending that we re-evaluate what we are doing. The State of California, for example, has gone to a statewide mentoring initiative as part of their drug prevention effort. You can teach these affects year after year after year, but by the time the kids have heard them four or five times, they are tuning out which is why they don't remember it anymore. So I really think we need to look at - and that's what we plan to spend this year doing which is going out and conducting hearings and doing focus groups to hear from the young people, their parents and the educators what is working, what is not working, what should we be doing differently and really looking at the research is about what is effective drug prevention. SEN. GUNTHER: Well I am surprised that they don't know whose teaching and they don't have even in the peer side of it, even if it's not the young people doing it, at least that our educational system, apparently with the stats I heard this morning, went through out drug policy committee meetings and heard how things are getting much worse and that type of thing that whatever we are doing now apparently is not doing the job. That's for damned sure. And I have great criticisms that the educational system has failed miserably in teaching the young people anything about it so that whatever program has been up to now, and if we are going to continue on just bringing in the educational system and have them teach, to me, being in the professions, I would say it's a health problem. Health providers ought to at least give them the real meat and then let the young people, maybe their own peers, take and do something about it, but the education system is not doing it. SUSAN PATRICK: I would like to remind people though that the drug use rate did fall by 50% among both adults and young people when we first began the drug prevention program. SEN. GUNTHER: Was that in the 80's? SUSAN PATRICK: That was in the 80's, but then all that funding was cut so schools let a lot of those people go that were doing that work. So I think that has something -- plus the approaches that were effective when we started this fifteen years ago, are not -- are now outdated and so we are not keeping up with the latest research. SEN. HARP: Thank you. Representative Nardello. REP. NARDELLO: Thank you very much. First, I would like to thank you for coming here because I think it's extremely important that you are involved in this effort and I think that sometimes we sit up here trying to make the decisions for a group that we have very little to relate to and I think your input is extremely important. Regarding -- just before I forget one, I address Senator Gunther's health issues. As a health educator having a degree in health education, I can tell you that the emphasis on the health education has actually decreased over the years, Senator Gunther. If you look at the City of Hartford, because of budget cuts, there used to be about 23 health educators. There are now 7 to serve the entire city. I think it may even be less than 7 at this point. And what you've got is that curriculum component for health is being put on teachers who have many other curriculum demands that health becomes a very small part of the curriculum that is not emphasized and you are asking them to do something that they are truly not prepared for because you don't have the person that has the background in health education. And we, as a State, do not mandate any type of health education and that's part of the problem, as well. But the thing that I wanted to ask you that I was concerned about, was the fact that as you gave your statistics, you said 25% of the people are using drugs and 75% of the people probably are not. Can you identify for me what's the difference between the first group and the second group? From your perspective, how do you see these kids over here that are not using drugs, what's one of the biggest differences and these kids here that are using drugs? LAURA BAUM: I think that a lot of it comes from the home, obviously and that people who do abuse drugs either come from families where it's not -- where it's accepted or where they don't have the kind of relationship with their parents where they can talk about it. I think it's a matter of the education or schools target certain kinds of people, generally and that the people who need it most may not be the ones who it is affecting. And so then they end up as abusers of drugs. I think that -- you know, that there are a lot of things that separate why someone uses drugs. I think the media plays a huge role and that people need to -- students need to know how to -- to know that what they hear on the media may not be the best way and that things that are glamorized in the media are not necessarily what is right for them. DAWN SANETTI: Also something as simple as the activities that somebody does after school. You can't like force anybody to do like an activity they don't want to do like a sport that they don't want to do, but if they are involved in something it leads them away and there is something else to do besides going out and doing something illegal. Last year I was on the spring tennis team and one girl was on it for a couple of weeks, but then she quit because her friends didn't want her to do it anymore and like she smoked so like she couldn't play very well. So I mean I try and do sports and I know that if I do any kind of drugs that it will hurt when I try to do my best at. So I mean the activities that people do and it is just something else to do and another reason not to do illegal drugs. REP. NARDELLO: And I also have a question regarding do you feel that in that decision, that first decision to engage in illicit drugs, you are going to make that decision, you are going to say, I think this is a good thing, I am going to try it. Do you think that pressure from peers is what brings people to that decision or do you think that that's something they personally choose? DAWN SANETTI: I think that peers have a tremendous impact on their -- on other students and if that people, not only in the -- we -- as many people think of it as the do drugs, you'll be cool, but if they are just hanging out with people who do them or see people who are doing drugs and feel like they would be a minority by not doing drugs and that there would be something wrong with them by not doing drugs and that kind of peer pressure has a tremendous affect. REP. NARDELLO: And do you think it would be effective if we had more students -- I was intrigued by your mentoring comment because I do think that that is an important component that's missing out of the health education component. Changing health behaviors as I think we can all acknowledge up here is a very difficult thing, albeit it smoking, drugs, or whatever it may be. It is probably one of the most difficult things to do because it is a lifestyle change and the mentoring aspect seems to me that if you could speak to other students, if you could get them involved and say to them, come on the tennis team - come on swimming -- let's do some other things, that would probably be more successful than some of the things in terms of lecturing. The information needs to be brought out as well, but I think that should be an adjunct. SUSAN PATRICK: The latest research says -- REP. NARDELLO: I would like to ask the girls if they thing that though. SUSAN PATRICK: Oh, I am sorry. LAURA BAUM: I agree. I think that an adult getting up and preaching in front of a class doesn't work and I think -- I mean it works early on and I think it -- I mean like in the D.A.R.E. Program and everything it works, but I mean like I said, we all start to realize that we can disagree with an adult and usually get away with it and everything. But if it comes from a kid -- if it comes from another kid whose pretty much close to our age group, it sounds more real and it sounds like they know more what they are talking about and I mean sometimes they can even give personal experiences or -- and it sounds like they know more what they are talking about -- I mean, it has a bigger impact if you hear kids talk. REP. NARDELLO: Thank you very much. I really appreciate your input. I would like you to continue to do so and I would like you to get more of your friends involved, as well, both those that do and don't engage. SEN. HARP: Thank you. Do we have further questions? Yes, Representative O'Neill. REP. O'NEILL: You are describing these things that you think would -- the mentoring and that sort of thing would work. Is this based on other programs where that has been successful that you've had experience with in your school systems or seen some other kind of context? I don't mean necessarily drug programs, but on some other subjects? Why are you -- other than just kind of an intuitive sense that you would take more seriously something that is said to you by someone your own age, do you have the impression that this has worked a change in other areas? Or in the drug area? LAURA BAUM: I think from personal experience, I've seen that people are more inclined -- students are more inclined to listen to their peers. We've had some older students come back to the high school and talk about issues that have affected -- drugs being included, as well as other issues. And just from students hearing it, from someone else who is like had the same experiences so recently and knows what it's like to go to high school in the 1990's is really important. Also, being -- I am a mentor for an elementary school student in New Haven and I -- you know, being part of the programs like that, I can see that it just makes a difference when you can relate to the younger person and there's certain health teachers in our school -- I think there is even like - you know you just walk in there will immediate disrespect because you know who the person is and for whatever reason, you may not like him and therefore you are not going to listen to him all year. But if it is a variety of students who you respect, then it can be a lot more effective. DAWN SANETTI: Also another member of Drugs Don't Work Committee, in her high school she says that the seniors do go out and I think they teach like freshman and sophomore health classes and it seems to work very well and the students enjoy it much more and they learn a lot more. So it has worked before. SUSAN PATRICK: The research also supports that those have better results. The newest research on effective drug prevention says that there are three factors that distinguish the kids who use from those who don't. Kids who have a significant older person in their life who believes in them, kids who have something that they are successful at, and things who have positive, pro-social kinds of activities that they can be engaged in that are alternatives to getting into these other kinds of difficulties. And we don't have those approaches systematized through our drug prevention efforts in the State at all. REP. O'NEILL: But I mean -- are all three components need to be in place for -- okay. SUSAN PATRICK: Yeah. REP. O'NEILL: Because I mean supposing number two there on the list -- I mean we could probably try to find some other adult or an older person to takes an interest, but we are not always going to make people successful at something. I mean we can give them other activities. We can take care of number three, but we can't guarantee that you are going to find some sort of activity that you are going to be successful at unless you are defining success other than winning the 100 yard dash or something. If you are just saying success is -- you completed the program or you showed in up, in some way. SUSAN PATRICK: Well, I think what the research is saying that every child needs to be successful at something in order to have a belief in themselves and to have some sense of hope for the future and you are right, it may not be academic, it may not be athletics, and in those cases, we really need to work to identify what are the strengths and abilities of that child and build on that. One of the most powerful effects of mentoring is when the kids themselves become the mentors. So you can take a troubled young person, for example, pair them with a younger person where now they are a positive person instead of the negative view that they have of themselves. So I do believe that there are ways to structure those success opportunities for kids, but it takes some extra thinking and effort. It doesn't come naturally for every child. REP. O'NEILL: Okay. I think -- I am sorry, I didn't get your name. So the lady in green. LAURA BAUM: Laura. REP. O'NEILL: I don't remember you answering the question that was asked about the kinds of drugs that might be in your school. Are we talking about or did you because I was distracted at various times. LAURA BAUM: No. Go ahead. REP. O'NEILL: So, when you are talking about drugs, are we talking about predominantly marijuana or are there other things, cocaine, heroin, psychedelic, what are we talking about? Or alcohol? LAURA BAUM: I think that the most -- I think that all of these -- that there are people in my school who use all of the drugs. But the most prevalent drug that I see during the school day is definitely tobacco and it is abused, it sounds like a lot more than in Dana's school. You cannot walk into the bathrooms in my school and -- without -- you know, being totally enveloped in smoke and cigarettes and so that is very prevalent. People smoke all day. People get caught and then they have -- there have been times when teachers have taken pictures of students with cigarettes in their mouths and the parent will say, "Oh my kid doesn't smoke cigarettes." There are people who just find ways to get around it. So smoking is the most prevalent. Alcohol use is very prevalent and then -- people smoke - I've noticed a big change from 9th to 12th grade in my high school experience. When I was in 9th grade people were smoking cigarettes outside. Then they started smoking cigarettes in school and now I see pot in the parking lot a lot too. So I think there are a wide variety of drugs. REP. O'NEILL: Is the pot in the parking lot a new or more recent innovation or is that sort of -- you were describing several progressions of tobacco outside -- tobacco inside and now pot outside. So was the pot outside before or you just didn't notice it? LAURA BAUM: I don't know if I didn't notice it. It is definitely becoming more apparent. REP. O'NEILL: Thank you. REP. LAWLOR: Our newest colleague. REP. MANTILLA: Can you say my name? REP. LAWLOR: Evelyn Mantilla. REP. MANTILLA: Thank you. Thank you. I apologize for having to step away for a minute. I have a couple of questions and I may have missed part of the train of thought that we were in the middle of right now, but I was looking with interest to at your statistics on the success of prevention. How successful has prevention been and I see these interesting numbers and charts that show us that where we have spent more money on prevention. We've had less arrests and so forth and so on. I represent the 4th district in Hartford which clearly is also one of the poorest districts and also represent large African-American and Latino communities. I was interested in asking if you know of any data that maybe similar to this, but with a cut on race and ethnicity? I would be very interested in finding out more as to how our prevention programs, what we do have, or where we have made such efforts may have made a difference, one way or the other, based on race and ethnicity. SUSAN PATRICK: Yes, I can send you some information on that and I will do that. One of the things, for example, that the Partnership for a Drug Free America did was an intensive media campaign in New York City aimed specifically at African-American young people and at the time that the drug use in the rest of the country started going up, it stayed down in those kids. The data also shows that urban children have lower rates of drug use than suburban children and the newest survey on the attitudes shows that the higher the income level, the more positive the attitudes are toward illegal drugs. So the lower the income level, the more negatively kids very drugs. Also, the more affluent the family, the less likely they are to believe that their children will do drugs, which I am sure then influences the kids' attitudes. REP. MANTILLA: Just for clarification, let me understand this really clearly. You said that the difference between urban youth using substance and suburban youth using substance is actually higher for the suburban -- SUSAN PATRICK: Suburban have higher rates. Now part of that may be because there is a higher drop out rate and drop outs are more likely to be drug involved. So it is really -- but there are also some other studies that have been done of the drop out populations that, I think, are also in some of the reports, but in general the rates seemed to be higher in suburban communities than they are in urban communities. REP. MANTILLA: That is very interesting. SUSAN PATRICK: We also found that from the survey we did of school violence, for example, there were more fights and weapons in rural and suburban than there were in urban which is a surprise. REP. MANTILLA: Not to all of us. It's not. I am very excited to see the work that the advisory committee with the youth is doing so I would be interested in the same vein then to ask, how large is the actual advisory committee with youth like you participating? How many members do you have? LAURA BAUM: There are about 20 members of the Youth Advisory Council. REP. MANTILLA: Great! And do you have somewhat of a representation of Latino and African-American kids? LAURA BAUM: Yeah. REP. MANTILLA: (INAUDIBLE) as well? LAURA BAUM: There is line range of geographic -- REP. MANTILLA: Great. LAURA BAUM: - race, everything. REP. MANTILLA: Good. Good. Great. SUSAN PATRICK: We always welcome new members if you have someone you would like to recommend. REP. MANTILLA: Give me a call. SUSAN PATRICK: Thanks. SEN. HARP: This is sort of on the same vein and maybe it's more of a reflection or a comment, it's interesting to me that there are higher incidents of drug use among kids in suburbia and yet there's higher arrests of kids in urban areas. And that the prisons tend to look pretty much like me and Representative Mantilla and that their complaints in suburban schools based upon what the young lady said that there aren't arrests made there when there are drugs dealt. I don't know. That is just kind on a interesting thing to reflect upon. SUSAN PATRICK: It's very typical in suburban communities for parents to raise such a stink that nothing happens. They don't like to be told that their kids are drug involved. SEN. HARP: Representative Farr. REP. FARR: I just wanted to make one comment. Your comment on what's effective in terms of prevention of drugs. I spent a lot of time on the issue of teen pregnancy and the reality is that those same things that prevent drug addiction also prevent teenage pregnancy. SUSAN PATRICK: Which is why I think we need a state prevention plan so that all these things are working in concert. SEN. HARP: Thank you very much. Debbie Blesso is our next speaker. DEBBIE BLESSO: Thank you for letting me speak. I have never done this before so I am a little scared and nervous. I don't have a speech or nothing so I am going to speak from the heart and my experiences. I was (INAUDIBLE) for seventeen years and I was on the streets most of that time in and out of my mother's house to change and go back out. I have done a lot of things that I'm ashamed of, but I had to do what I had to do to support my habit. And a lot of people, high up people like yourselves don't know what it is like unless you go through it or know somebody who has been going through it because it really -- the streets are bad. There's not no place for nobody to be. And if it wasn't for this person here that helped me get off the street, and the man upstairs, I'd be dead because I should have died many times doing what I was doing out there, but -- jail is a joke. I was in and out of jail for like ten years of my life. During it started to get better because I was trying to get help for myself. They send you out of jail with a packet, condoms, okay. And with no money, with nothing. They drive you right back in the area, drug area, matter of fact, around the corner from it, Lafayette Street. What's a person going to do? You can't go home. You don't want your mother seeing you like that. You are going to go back to the same things you were doing before so you are going to end up back in jail. Okay. So it's a big joke to me, jail is. It doesn't help you at all. They de-tox you like that. A drug addict needs more time. They need a lot more better medical attention in jail, if you ask me. People who really know what they are doing and know how to deal with a severe drug addict because you cannot de-tox in six days. No way. It took me -- I have been clean three years and I thank God for that and her. SEN. HARP: Thank you. Are there questions? Yes, Representative Farr. REP. FARR: Are you also using Methadone? DEBBIE BLESSO: Yes, I am. REP. FARR: And you have been using that for six years? DEBBIE BLESSO: No. For three years. I have been clean for three years. But I have been off the street, you know, trying to better myself. REP. FARR: Okay. And how did you get into the Methadone program -- DEBBIE BLESSO: She helped me. REP. FARR: Okay. But it wasn't through the jail -- it wasn't at the -- DEBBIE BLESSO: No. They didn't help me do nothing. REP. FARR: Okay. DEBBIE BLESSO: Back then when you get out of jail it was at least a year waiting list to get on it. REP. FARR: And the Methadone Program, is that in Hartford that you are in? DEBBIE BLESSO: Yeah. REP. FARR: And you have to go there how many times a week do you go? DEBBIE BLESSO: I go every day. REP. FARR: You go every day? So you are still monitored. Okay. And are you employed now? DEBBIE BLESSO: I get two take homes. I am building up my take home. REP. FARR: And are you employed now? DEBBIE BLESSO: No. I am on social security. REP. FARR: Okay. Thank you. SEN. HARP: Thank you. Representative Winkler. REP. WINKLER: Thank you, Madam Chairman. Debbie, thank you for coming before us today and sharing your story. DEBBIE BLESSO: You are welcome. REP. WINKLER: I would like to say part of the problem is the fact that we don't have any substance abuse beds for women in this State. DEBBIE BLESSO: Yes, that's true. REP. WINKLER: Unless they are pregnant. And I think that's a real -- DEBBIE BLESSO: It's not right. REP. WINKLER: -- that's a major issue. It is a real crime because there are all kinds of beds for men, but nothing for women. And until we beef up that area, we are going to have a lot more problems. But thank you and I think that that's part of the problem. YOLANDA REDIN: Can I say one thing? As far as the children -- they were talking about the kids and their statistics, I think reading in and out of a book -- there's nothing to be said for that. Unless you've been through it, you don't know what it's all about and I think as you look into somebody recovering, maybe talking to these kids and letting them know what the streets are like and what it's like to survive in the streets and living in rat infested buildings, putting your head down wherever you can. Do you know what I am saying? And maybe that would be more use to a kid than somebody talking to them because they read it out of a book, they know something, you know. Unless you've been there and experienced it, you'll never understand it. You know what I am saying? Thank you. SEN. HARP: Thank you. Are there further questions? If not, thank you very much. Peter Rostenberg. Is he here? Followed by Imani Woods. PETER ROSTENBERG: Hello. Good afternoon, ladies and gentlemen. My name is Peter Rostenberg. I practice internal medicine and addiction medicine in New Fairfield for the last 22 years. I have also been Medical Advisor to (INAUDIBLE) Vocational School in the New Fairfield school system. If any of you went to the Methadone luncheon the other day, you saw the treatment improvement protocol on State Methadone programs. I also chaired one of those federal consensus panels on injury and alcohol in hospitals which focused primarily on screening, asking patients questions about risky alcohol and drug use which generally does not take place in Connecticut or anywhere else. I am also Connecticut State Chair of the American Society of Addiction Medicine which we refer to as ASAM. I am here today primarily to represent the views of the 45 physicians or so who are members of this national organization. ASAM has about 3,500 members, physician members nationwide. Many of us have studied the body of knowledge of addiction medicine and one of the several text books on the subject -- there is a certifying exam and we are fortunate in Connecticut to have several ASAM members who are considered competent in the area of addiction medicine and I am hoping that in many of the laws that you all look at that you will run it by the screen of providing the opportunity for those of us who are not in facilities, those of us who are in much lower overhead situations to be able to provide the high quality of care that you want the citizens of the State to obtain. So I would hope that there would be linkages for M.D. treaters. I would like to mention, first of all, some topics on Methadone. My interest began in this area with the Governor's Blue Ribbon Task Force and Dave Biklen was one of my partners in the committee I was on. As I said, my interest is in alcohol screening and I am going to say a word about that. Alcohol is the third leading cause of premature mortality in this country and yet there is a code of silence when people come to the hospital with alcohol related admissions, whether it is injury, which is the leading cause of death attributable to alcohol use or certain other medical illnesses that are very highly related to -- correlated to alcohol use. We do not see them being talked to and one of the things we've learned about risk assessment and Healthy 2000 is that citizens want to know what their risks are. They have a good idea of what their risks are and they want to have choices. And we do not give them those choices in this area and what happens, they continue to use, when the leave the hospital. We have to recognize that there is a, I believe, an ethical economic and appropriateness to that aspect of asking patients questions. My interest in Methadone, as I said, was started with Dave Biklen, I thought, but as I listened to him and heard him, and heard his pleas about maybe writing something about Methadone, it made me realize my own background was very much involved with Methadone and I got hooked on the issue of Methadone. My internship and residency took place in a New York City hospital which was primarily poor, inner city, totally African-American and most of our admissions to this 850-bed hospital were alcohol or drug related. And these people who were coming in were often on heroin and interestingly, because I was moonlighting at the tombs, which they mentioned at the luncheon and I will say about the tombs which they have since torn down, that the halls were so narrow that you had to walk like this through the halls. And I also worked at Rickers Island Prison where the Methadone program was just begun. I didn't know it was brand new. But I had occasion to see some young men that I had treated at Harlem Hospital where I trained at the prison and some people I saw at the prison I met later at the Harlem Hospital Emergency Department where I worked after my training as a full time medical attending in that emergency room. What I have since learned about methadone is that it was primarily -- there are no feds here, I hope. It was primarily developed by people who believed that the barbarians were at the gate and we were trying to keep them from our houses and I have since learned that the barbarity here is the programs themselves. That these are so highly restrictive, they are so difficult to get into, that they are doing a lot of harm, not for necessarily the people they are taking care and who can learn to live with that, but the demand as somebody said, there - all these programs are 100% full. What we need to do is to find ways to entice people away from these highly restrictive programs and get them into more medically appropriate, more cost effective kinds of interactions. I see a methadone maintenance program as an intensive care unit for some of the sickest opiate dependent people. But the bell shaped curve of illness, of disease, if you will, can put -- they are on the very far right of that bell shaped curve. As people go through that program they move to the left hand side of that curve. They recover. There is no evidence that people do not recover from addiction. Even heroin addicts. They need to be moved out. When those people are stabilized, we need to move them away from that program and into a less -- I would call, less of a prison-type of situation. We doctors in the American Society of Addiction Medicine are able to provide high quality, low cost care, lower cost care. At the luncheon we had yesterday or the other day, a recovered person, ten years into being into the methadone maintenance program is still costing the State $5,000 a year. There is no need for that. There is also and I have learned this since I have moved to basically a white middle class community that there are a lot of white middle class people who are hooked on opius. And they don't choose to go to these programs. They are employed. They have families and they struggle with this addiction and some of them, I believe that I take care of, would be more appropriately treated on methadone. REP. LAWLOR: Excuse me, Doctor, perhaps members of the committee have a question. PETER ROSTENBERG: Does anybody have a question? REP. LAWLOR: Representative O'Neill. REP. O'NEILL: Based on what we heard yesterday and I guess most people who are here now were there then. I mean, yesterday the programs that were presented to us essentially were very long term, essentially life long and for many people, unless they made a voluntary choice to eliminate Methadone from their lives and to reduce gradually and they made it sound like it was several years, it wasn't like a few milligrams a month until you got down from 80 to zero, are you saying that you think that after a year or two on methadone that people should then be moved off of the methadone programs or are you talking about something like that Maryland described program where doctors are issuing it and it essentially is not part of a regular program -- not part of -- not that it's not part of a regular program, but you are still getting the methadone, you are just not part of the clinical setting? PETER ROSTENBERG: I am saying that there should be choices available for these patients just like we want to know that there are choices for any other medical condition and that their criteria for improvement, their criteria for recovery and the methadone maintenance programs should not be chronic care facilities. They should be intensive care units for people who are the sickest. REP. O'NEILL: Yeah, but if -- PETER ROSTENBERG: If you move people out of there using established criteria of recovery and stability they can move onto less intensive programs making this more intensive kind of entity available to more people. REP. O'NEILL: So when you are saying less intensive programs you are talking about continuing to use methadone, but for example, having a doctor at a more distant site perhaps, providing -- somebody sort of connected to these programs. That was one of the options that seemed to be presented to us. Or are you saying that they should basically be weaned of the methadone? PETER ROSTENBERG: I have a problem with the bill that I saw where it said the doctor had to be affiliated with these programs because a lot of times the doctors who are affiliated with those programs really don't know much about addiction. They have simply gone through the boiler plate of becoming federally approved. What I am asking you to do is to always think about is this person qualified? Both the American Society of Addiction Medicine and the American Psychiatric Association have added qualifications in the area of addiction medicine or in addiction treatment care. Those are the people you want to focus on, identify, focus on and talk to more people than myself about this to see what opportunities you have to give the patients choice. I think when you give people choice you increase demand. And when you lower the treatment to the lowest cost, HMO's are going to like it -- believe me, HMO's are not going to want to pay $5,000 a year for somebody whose been clean and sober and employed with families for fifteen years. No way. And I would agree. Does that answer your question? REP. O'NEILL: Not really. The $5,000 was really, I think, the point that they were trying to make with the $5,000 and maybe sometimes we use evidence that tends to bounce back at us, but the purpose of that was to demonstrate how much cheaper that was than the other options that keeping somebody in prison for the same length of time or some other similar kind of very much more expensive -- having somebody on the street which was the most expensive where they are actually stealing and doing all sorts of mayhem as well as eating up resources of the police department, the criminal justice system once they are caught and that sort of thing. I mean the $5,000 was actually, on a scale of things, that was actually the low cost alternative of what what was put on the charts presented with. PETER ROSTENBERG: Well, I am here to tell you that there is a much lower cost. REP. O'NEILL: I guess what I am trying to figure out is what is it that you are telling us that is the lower cost? Is it -- regardless of how we classify or how we reach that point, are you saying that a doctor in his own office issuing methadone tablets or liquid is what you think we should be doing to move people out of these clinics? PETER ROSTENBERG: I think that disease management -- this is sort of the Rubric that is used. Disease management. Institutions like to run because they get to be able to provide all kinds of services. That doesn't mean the patient needs all those services. It means the institution can get reimbursed for them and as we see the winding down of hospitals and survival of hospitals and of -- you are going to see more of that. What I am saying is that when a patient is stabilized and when they have a chronic illness that's in recovery, they don't need $5,000 worth of care a year unless they are on dialysis or unless they are on some kind of maintenance, chemotherapy like Interferon. It's just not needed. That's what I am saying. That $5,000 is a continuum of cost. And it's on a continuum of care. That's what I am saying and I am saying that it doesn't have to be an institution that takes care of this. And as I mentioned before, there are people who do not need to go through an intensive care unit; who do not need the lower intensity kind of treatment, but who still need treatment. For example, a patient of mine is 35 years old. He has a job, two young kids under ten. He is a heroin addict and occasionally he has a relapse. Now, I don't need to use methadone in him. But I have other patients who just can't seem to get clear. They go and -- I have a young lady, she's got about the same age. She's got two young kids. Her husband is employed at our local hospital. She just got arrested for forging a prescription after being clean for three or four months. I think this person is a candidate for methadone. I can't give it to her. REP. O'NEILL: Okay. So what you -- to try to get a handle on what you are saying is you think that methadone should be sort of like other drugs that you can prescribe. In other words, there should be a prescribable drug by a physician -- PETER ROSTENBERG: It should be prescribable by people who are qualified, given stringent criteria for dispensing the way we do with other drugs. For example, medical marijuana. PETER ROSTENBERG: Well we don't dispense medical marijuana in the State of Connecticut to my knowledge. PETER ROSTENBERG: No, I know we don't, but I am sort of introducing that as an aside, is what I believe is a medically appropriate tool in the (INAUDIBLE) of practicing physicians. REP. O'NEILL: Okay. I think I've got a better picture now. So you think that the people, the prescriptive authority should be limited to people that meet higher standards than just the average M.D. or advanced practice nurse, practitioner, or other people that now have -- optometrists, I guess have prescriptive privileges of one kind or another, but instead of having just any doctor, just any medical doctor be allowed to prescribe that, it would be that somebody who has credentials similar to yours would be allowed to prescribe methadone? PETER ROSTENBERG: Yes. REP. O'NEILL: Okay. Thank you. REP. LAWLOR: Okay. Thank you very much, Doctor. Imani Woods. IMANI WOODS: Thank you. I have certainly learned much today while observing your unique fashion of hearings. While I've heard some very interesting approaches today and I am also very happy to have been invited here to speak, certainly I -- over these (GAP IN TESTIMONY - TAPE STOPPED RUNNING) Connecticut has a place where we may actually begin to make some headway in this seemingly impossible problem. I would like to address some of the comments that were made earlier (GAP IN TESTIMONY - TAPE STOPPED RUNNING) all over this country. Thirty-nine percent of the entire cigarette and alcohol budget is spent in communities of color. Thirty-nine percent. That's the only place where a group of people or a specific business takes that much money and puts it into the Black community. Prevention also has to be backed up by opportunity. In these communities where you have massive unemployment and we know unemployment is a key indicator for excessive drug use, where we have unemployment, where we have no opportunities and where we have drug treatment that may not be culturally appropriate, you have individuals who this is the norm. Over the years and the ten years that I have been working in this field I have discovered something in which I named in 1989 as a substance using community. A group of people who have a different jargon, a difficult lifestyle and totally different values than you or I may choose to espouse to. Those individuals who are, I feel, benefitted from the just say no and some of the prevention efforts that we are familiar with are individuals who probably wouldn't have took that route anyway. I'm sorry to say and the -- how do we get our statistics on who is using and whose not using? I am sure some of you probably know that we do it by the NIDA household surveys, The National Institute of Drug Abuse household surveys. In order to be eligible for NIDA household surveys first of all you got to have a house. They got to have somewhere to knock. Secondly, how many people when you go to their house to do a survey and say knock, knock, is there anybody in there getting high? I mean, you know, not everybody is going to answer and give you an accurate answer, oh yeah, well three of my sons are using in the bathroom right now. You are not going to get that. Also we give our drug users mixed messages. I don't understand - because we are talking about mixed messages earlier. What confuses me and maybe you can help me is we say that drug abuse, substance abuse, chemical dependency is a disease. Okay. So since it is a disease, how come we are not sending sick people to the hospital? Why are we sending sick people to jail? I'm confused. I thought sick people go to the hospital and get care. Some of the recommendations I have is or rather -- we really need to shift to a public health model. Looking at drug use is just one more problem that affects a certain population of individuals and has far reaching impact to the general society as a whole. Secondly, I support reality based programming in communities. Meaning that drug treatment, the opening up of more drug treatment may not be the answer. I certainly believe that we need to have drug treatment, but demand and that drug treatment needs to be available. However, there are other approaches that we can take such as drop in centers, community initiatives where people can just walk in and receive care, service, and basic needs. We have to include and examine the social and political aspects of drug abuse. We all know that in communities of color, communities of color in America have become the drug distribution ground and drugs are readily available in those communities. How can we penalize people so strongly for something -- it is like putting a cookie jar on the table and telling the kid not to touch the cookies. I know I am over, but for one minute I would like to depart from my speech and tell you a little bit about me, which was not something that I planned to do, but which I feel maybe appropriate at this time because there seems to be so much confusion and lack of understanding. I grew up in (INAUDIBLE) in New York. When I walked out of my door every single morning, the dope man was outside our door. My mother worked very hard. I attended Catholic school and Catholic elementary school and Catholic high school. My mother believed that by sending me to private school that that would be an effective way to keep me okay. My family was very strict. They are very strict west Indian based family, work -- very strong work ethics, a lot of pride. Every single day, however, when I walked out of my door to go to Catholic school, the drug dealers were out there. The drugs were out there. It was a whole different society and by the time I was 17 I had -- I got inquisitive. I spent 10 years in the street. How did I get clean? Well, I got clean because people cared about me. I got clean because I got on the methadone program. I got clean because the methadone program gave me enough strength to sit down and finally listen and come to terms with what I wanted to do. This day, however, I do wonder if drug policy reform had been different, what my life would have been like. Most of my friends didn't make it. Most of them died and the kids are in foster care or so forth. Today, I have been drug free for fifteen years and I don't have a problem with other people that are not drug free, but I will say that compassion is the most successful way to get people involved in drug treatment as well as an understanding of the social and the political aspects of drug use and my irresponsibility as a public health official for not working with people to eliminate the problems in their community and then try to help them gain an upper hand in society. Any questions? REP. LAWLOR: Thank you, Imani. Are there any questions? I think for those of us who listened to the presentation this morning, I think we have gotten a lot of good advice and counsel from your particular perspective and we appreciate you coming all the way from Seattle, Washington, which you didn't point out earlier today and we appreciate it. IMANI WOODS: No questions? Representative Farr. REP. FARR: I guess I could ask you, how's the weather in Seattle? My son lives out there and I am curious what -- IMANI WOODS: How's the weather? REP. FARR: My son lives in Seattle. I am just curious to what it was like -- IMANI WOODS: You don't have any questions? I am surprised. REP. FARR: I do have one question for you. IMANI WOODS: Oh, okay. REP. FARR: You made a comment about the -- when you were in high school and that you got curious because people were selling drugs out in the street. Is it your position that we ought not to be arresting people for selling those drugs on the streets? IMANI WOODS: No, it is not. It is my position, however, that and certainly my -- I think in terms of the kind of criminal laws we have, I have priorities. I my first priority is that the non- violent offender not go to jail. It doesn't make any sense. Again, we are in the middle of this controversy. If it is a disease, how come they are going to jail? It's the only disease, by the way, that people do time for in this country. I do believe in some cases that the street level drug dealer is responding to the market and as long as there is a demand for drugs in these communities, and it's illegal, that man is never going to be out of work. REP. FARR: Let me ask you then, as long as it is illegal, I mean if it is legalized, obviously you are not going to reduce the demand by making it legalized. IMANI WOODS: Certainly not, but as long as that market exists -- I mean, you probably understand. You remember Joe P. Kennedy, don't you? I mean, prohibition. He made tons of money. REP. FARR: And we legalized alcohol and now it's a disease that takes a far greater toll on our society than the other drugs. IMANI WOODS: Right. Right and Al Capone made millions because of alcohol at that time was illegal. So my point is not the whole -- I am steering clear of legalization issues, but what I am saying is as long as we create a market for the street level dealer, he is -- he or she is going to continue to operate. Very often these people have no job skills, but they go home and they watch the lives of the rich and the famous. So when they go to McDonald's and McDonald's says $5 an hour, they don't see a Mercedes Benz. So, they figure they will get involved in it for a little while and they will be able to get out. The stories of the people in these neighborhoods are stories that are very different from what I believe, not sure, but what I believe you or even I today may hear, but it's a very different kind of thinking and if we begin to say, well just lock them up, just lock them up, just lock them up, basically what are we -- what we are saying is, let's just lock the persons of color who are drug users. REP. FARR: Let me just say, first of all, there is no crime against using drugs. The crime that you would be arrested for would be the possession of the drugs -- IMANI WOODS: Right. REP. FARR: -- themselves. And there are very few people in our prisons that are there strictly for "possession of drugs". Most of the people that are there are selling the drugs or have large quantities and obviously are in the sale of drugs or there are people because of their drug problems, have committed other crimes. IMANI WOODS: Right. REP. FARR: And when people say that people ought not to be in jail because they are committing non-violent crimes, they usually -- the people who are in jail for the non-violent crimes are usually people who commit burglaries and in my experience in my community, is that we had two young men that were apparently using drugs that got involved in doing burglaries. There was a warrant out for their arrest and in my community, they weren't picked up in a timely fashion, they committed another burglary and when there two -- a couple in that house that they were burglarizing, they took the lives of that couple. Now they are in jail. A lot of people felt that they perhaps it would have been appropriate to intervene in the legal sense prior to them getting that opportunity. REP. LAWLOR: If I could just interrupt. There is a vote taking place in the Appropriations Committee. I think we -- Art, do you want to drive for a minute. REP. SCALETTAR: Terry is going to do it. REP. LAWLOR: Oh, Terry is going to do it. Okay. Terry is here. REP. GERRATANA: They'll be right back. Does anyone else have any questions or comments for Ms. Woods? Art, go ahead. Representative O'Neill, go ahead. REP. O'NEILL: I guess I'm not absolutely sure about this and I don't want to get into an argumentative situation here, but we actually do incarcerate other people for other crimes that are also recognized as having a disease component. I mean the ones that come to mind most often are things like pedophilia. I mean -- you don't go and generally plead insanity to a child molestation charge. You may end up getting some kind of treatment, somewhere along the line, but -- and there are others. I am sure there are kleptomaniacs that we put away. We don't send them off to some mental hospital for the most part. If you are somebody very wealthy or famous, if you were one of Joe Kennedy's grandchildren or something, they might do that, but if you are everybody else, you will probably get picked up for shoplifting they are going to put you in jail after a while. I guess the thing that I am wondering about is you have sort of -- I wasn't here in the morning so I don't know what your comments were. I gather you did comment this morning. You were part of the discussion that occurred. The kind of things that we are thinking about -- I was on the Law Revision Commission Task Force -- I was a member of the Law Revision, but I also sat in on a lot of the discussions and went through a lot of the material that we used to put together the report that was issued by the Law Revision Commission. It seems to me that there are a lot of -- there are different aspects of this problem. In other words, the heroin problem -- you people can talk about methadone, but to my knowledge, there is nothing comparable to methadone for cocaine. The biggest probably single substance that gets abused is alcohol. Again, I don't know of anything that you take -- some other liquid that you consume besides alcohol and alcohol is a much broader based kind of thing, but it is a legal substance, regulated to some degree, but whereas the others are really pretty much illegal. I guess I don't know -- I am not sure where they fit on the schedules, but basically there is no -- normally you don't go prescribing heroin or cocaine for medical conditions. I suppose maybe its something somewhere that gets used for that way. Whereas alcohol you can go and most places we must have about 60 or 80 licensed vendors in my home town. IMANI WOODS: Right. REP. O'NEILL: And so all the different kinds of substances that get abused, it's a whole different set of situations. So I mean one size fits all or a -- you look at each of these pieces of it and it's a very different set of problems that you are dealing with and you are talking about. What I am wondering about is, in your experience in Seattle, and I gather you are involved with trying to deal with drug addiction problems there. That is the impression I get. What is it that works best, particularly -- I hate to say it quite this way -- I think we wouldn't be here if basically nobody was using heroine or cocaine. Probably not even if they were using marijuana. We wouldn't be here except for heroine and cocaine. And the inciting of that, certainly for the Law Revision Commission, to a large degree, was that we were looking at all the crime that we had and the fairly high body count that we had picked up in the State of Connecticut and from my perspective, the abridgement of civil rights as well that we are going through. We would let -- we let a lot of things go because we are fighting drugs. It is worth it to sacrifice certain civil liberties in order to get there as well as the fact that it costs a lot of money. We lock up a lot of people and we are putting convicted multiple murderers on the witness stand on behalf of the State of Connecticut and the federal government does this all the time. The spector of us basically being in partnership with somebody like Pablo Escobar. So that's -- we came at this from that perspective, not really so much a therapeutic consideration looking at well, how can we best treat people who have substance abuse problems. So putting aside alcohol for the heroin and cocaine things and in dealing with that, what's -- as I say, I missed this morning, so what would you suggest for us to do? IMANI WOODS: Well, in specifics, I specifically, I just want to point out that I came from drug treatment. I was a drug treatment counselor for many years. And I continue to work as an advocate for different -- for alternative approaches within the drug treatment community in this country. Also, your point is well taken about you know, people who are pedophiles or people who steal and kleptomaniacs and so forth. I guess I would say in response to that, however, that it's a very -- it's not a very widely utilized DSM for criteria. In other words, I don't think too many people, too many doctors write it down for their reimbursement purposes or that medical doctors in hospitals use that criteria very often for these other cases. Just a point, just making a point. We also aren't very sure about the process of the pedophile or the person who steals. We are not very sure. We have done a lot of research, however, on the alcoholic and the drug addict so we are really -- we are pretty much very clear in regards to what components and what indicators need to be present in order for us to look at it in that way. So we are pretty clear about the whole disease notion and some aspects of addiction and then of course, there are many other theories. What I think -- what I believe works, is that we have to come to terms with drugs. As I said earlier, I myself, came to terms with drugs for myself. But we still have to come to terms and make peace with drugs. You can continue this war and this war effort, but unfortunately, we have been not doing very well, you know. There are more and more people getting addicted to drugs and more and more people being punished for the addiction. One of the things that I really believe in is I really believe that it is not cost effective to put someone in jail whose a user. That's just my opinion. I also believe that most people who really want to use, when they get out of jail they are going to use again anyway and we are probably going home soon home anyway so I would like to present this little issue to the panel. Suppose somebody used, because they wanted to, -- it's like suppose I don't stop getting high because I like it. It does something for me. When I get high I don't realize. When I get high I feel better. When I get high I have confidence. When I get high I feel like I can achieve something, even if it's for a minute, but you know what, I like the way this feels. I can tell you for all the years that I have spent in the street, I am certainly not -- you know, I am certainly not stupid, I spent ten years doing it because I liked the way it feels and that is something I think we have a very hard time with grasping, removing immediately from the use to treatment. And treatment is very important, don't get me wrong. I am totally for drug treatment and I totally believe that abstinence is the way to go for most people, but I think that what we do and why we run into a lot of problems is that we treat drug addicts like babies. And what we say to the drug addict is you are sick and the only way that you will be able to do anything for yourself or your community will be if you stop. Well, the drug addict doesn't want to stop. So perhaps, or perhaps it's more important to them to use. So what do you do? Well, what I did and what I continue to do today when I go to the jail program that I keep in touch with and speak to the inmates is what I do is I say to them, you know what, I understand that you get high for a reason. I respect them. I say to them, you are not stupid. I know you are enjoying yourself sometimes. Sometimes not. But I certainly know, given the proper dose, you are having a good time or you are feeling relaxed. But right now sir, you are 40 years old. You have three kids you are not taking care of. You got a wife and family. It's time to put down the childish behavior. Period. I don't even - I try not to even focus on drugs. I try to explain to them that I understand that they are getting something out of it, but that now if you want to make different choices, it's time to put down childish things. So I think that -- also I think another reason why we are having problems with the teenagers is because we tell the teenagers that stuff is bad -- ooh, terrible. And they smoke it and they go, are they talking about the same thing I am talking about? So of course they don't want to go to treatment. They think -- of course they don't want to stop doing it. We are telling them that this is bad. They smoke it and they don't feel bad. They feel good. So what do we do? We hide it. We hide it from parents. We think, oh from the authorities, because we think that they must be crazy. Why aren't they appreciating what I am appreciating? The way to talk to kids is to say, if you smoke marijuana, I did this with my nephew and I won't take up too much point of time, but my nephew started smoking marijuana and my sister -- oh, my God, what am I going to do, what am I going to do? I have worked all these years, worked so hard to keep him clean. Don't get excited, number one, because he is going to smoke. I wrote him a letter and in that letter I wrote to my nephew. I said, "Dear Shawn. I understand that you are smoking marijuana." I didn't say I heard or are you because many times parents need to play that game. Are you smoking marijuana? Like the child is going to say, Oh, of course. Of course they are going to say they are not smoking. I understand you are smoking marijuana. Let me tell you what is going to happen or what kinds of things you have to be careful of. Number one, when you smoke marijuana, some studies say that it may in some way affect your driving. Living in Orlando, I know you drive a lot. You need to know that. Number two, because you are an African-American male, you will probably get stopped at some point particularly if you are in a car with a bunch of other African-American males. They will find the marijuana in your car. You will get -- you will go to jail for possession. You will be charged with possession. Because your mother has a very good job and you have never been in trouble before and you have a family that can advocate for you, you probably will not do a day, but it will be on your record and as an African-American male, that's one more strike against you. You need to understand that when you smoke marijuana you might get little yellow stains on your fingers which may affect what kind of job you can get. Lastly, I want you to know that I love you whether you smoke marijuana or not, but I want you to know that it is illegal. That's it. Being realistic about drugs for me has been the best approach and we created a program in Seattle, Washington called "Street Outreach Services" and quickly to tell you it was -- and you have something similar to it right here in Bridgeport with the needle exchange van that goes out, but at Street Outreach Services, we fed people. We helped people with clothing. We helped people with food. And then we said, now do you have any problems? Eventually they got around to talking about their drug problems and eventually we were able to talk to them about solutions. But hungry people, people living in the street, people that have been living that hustler life and that street life all their lives, when you send them to jail, public housing. Public housing. A rest. Showers. Fresh bed daily. Stuff I didn't have when I was in the street. Unfortunately, that is what you are going to get, not an individual who has become responsible. What I am talking about is responsibility. The addict needs to become a responsible person. We are babying them. We could take that $25,000 a year and take -- and just take $10,000 of it to put in an innovative job training and job readiness programs for these individuals so that they can stop walking around saying, "I can't get in that program because I am using." No, that's okay. Come on. We will take you. Come on. And by achieving in that state, that gives that person that little piece of self esteem so that they begin to think what's getting in my way and if it is the drugs, they will let it go. But when you have nothing and you have no hope, you are desperate, you live in these communities where there are rats and roaches all over your house, you come tell me about drug treatment? I am like, okay, I have been there before. If I ain't got no money I will probably go again, but if I got money I am going to continue to participate. So anyway, that is what I think. I know you are sorry you asked. I can tell by the look on your face. REP. O'NEILL: Well, in one sense, it -- in yesterday's little discussion a lot of what we ended up talking about was a -- that drug treatment is part of like a comprehensive medical program and then you kind of get -- and it -- for us to deal, at least for me, and when we look at a budget and we look at what we are going to do in terms of changing programs and so forth, we look at essentially specific targeted compartmentalized things and essentially say you have to remake this person's entire life in order to get it -- because the drugs is just a symptom of an underlying social or physical or other malady that they have. It makes the problem a lot more difficult to address. IMANI WOODS: I still -- just quickly in response. I think it is amazing what a little success can do. It's amazing that when people who have never had any achievement, achieve something, the change that comes over them. It is amazing. People who -- grown people who get a kick -- who brag because they passed a test or got their GED. And see when they have something, -- when you have something, then you begin to make different choices. But when you have nothing, it doesn't mean anything. I do hope that Connecticut can certainly serve as a leader in this effort because in this country, something has got to change. I was talking to Senator Harp today about the whole notion of the disparity and racial breakdown and because I have been fortunate enough through Ethan and other people to go and see what goes on in other countries, and talk with people from other countries, I realize that they have very innovative programs for dealing with their drug users. And I won't spend the time to go into it, but I mean I look at Amsterdam and Australia and I think you saved that much money, your programs are that cost effective? So with all due respect, it comes to my mind why isn't the United States trying to save money? Why isn't the United States looking for the most effective way to do this? Then I begin to think, I wonder is it because the jails are full of Black people? Latin people? If the jails were full with White American men, do you think maybe we would get something done? Just a thought. And I mean that in all seriousness because I talked to Senator Harp about it. But there is - it doesn't make sense to me that this country would not look for the most effective way to do things and that this country would do the same thing -- the people would talk about insanity is doing the same thing and expecting different results. Well that is what we are doing with the war on drugs. We do the same thing over and over again like this time it's going to work and it behooves me as to why within this society we haven't looked at something else, at another way when this way, obviously, has many flaws. Just a thought. REP. O'NEILL: Okay. IMANI WOODS: You missed it. Anybody else? REP. LAWLOR: We've got that transcript, you know. We are all set, but it's not going to -- IMANI WOODS: Okay. I know you can't wait to get to the transcript, Representative. Thank you. I really appreciate having the honor of being able to speak to you. When I was leaving Seattle I told my friends, now you guys make sure you watch CNN because you don't know, I may have an outstanding warrant in Connecticut. REP. LAWLOR: Okay. Thanks a lot. IMANI WOODS: Thank you. Will everyone look on the floor around them to see if they see a date book? It has a cloth cover and a (INAUDIBLE) on it. I could have dropped it somewhere. REP. LAWLOR: While you are looking, is Jerry Ainsworth still here? Jerry Ainsworth? Alright. John Hrabushi? UNIDENTIFIED SPEAKER: He had to leave. REP. LAWLOR: He had to leave. Anne Higgins. UNIDENTIFIED SPEAKER: Anne is here. ANNE HIGGINS: Is this working? I am Anne Higgins from North Haven. I am really impressed with today. I was listening in this morning and I thought this is -- I don't know, this is part of enlightenment beginning to happen here. I have been the Chair of a small committee in the United Church of Christ that has studied drug policy for two years now ever since I woke up one night and heard the child had been shot on a bus - school bus in New Haven and I was determined to try to be part of trying to solve this, that's going on. And gathered a few people who were interested and we read -- we interviewed police chiefs, professors, all kinds of people. We listened a lot. Some of us have read the whole Law Revision Commission thick report. I think it, in itself, is very good with lots of terrific research and wisdom in it. I would like to say three quick things. One is that you have people behind you if you are willing to make some changes. I know it seems politically unwise to try, but I believe there are many people more than even in our church who would be behind moving from incarceration as an answer to our drug problems, toward public health, toward treatment, prevention and education. I think there are many more people that are beginning to understand this. We had a whole church -- you may have heard of a church in Hartford where 80 people signed a petition in favor of the kind of thing that the Law Revision Commission came up with. We had a resolution where 400 of our church representatives last October suggested four specific things in our resolution of adjustments to drug policy were very similar to what we have been talking about today. I think you have much more of the public behind you than you think and any way you should be leaders. You should be our leaders. I also feel that prevention and education are terrifically important and have begun to look into, for instance, just on the surface I have talked to the woman who runs the drug education. It's a total thing. It's called Social Development in New Haven. I have looked at that. They are doing an evaluation this year to see where they have come along in the four or six years they have been doing it. It looks good to me. It looks much better than the kind of thing you hear about where the police coming in a helicopter into a town and spending, you know -- a few sessions with the kids. This is a total thing where the police are part of the whole drug education thing. I looked at the stuff for Boston. It looks very good. It's a whole part of the curriculum so that prevention and education are part of the whole -- trying to educate kids to look at their lives the way the speaker just before me talked about, look at your life and see what drugs are going to do to your life if you possibly can when you are a teenager, begin to look at that rather than just one emphasis on don't take drugs. Look at how the whole development is. The last thing I wanted to say is I have somebody close to me who is in one of our major drug rehabilitation institutions in the State. She is a drug counselor and she is very concerned about what managed care is doing to drug treatment. If we are going to move people and heal them instead of incarcerate them, and we are going to move them to public health treatment, we can't have managed care cutting the payment for the costs. Something has got to be done there. It has been brought down from something like a month's basic treatment to two weeks that includes de-tox. When you have somebody on ten or twenty years of drug addiction, you can't do anything in one week after de-tox. It's got to be better than that. So somehow our oversight of managed care has to be included. REP. LAWLOR: Anne, it's funny. You mentioned that and you live in North Haven and I live in East Haven and I think you know about our town. It's a very middle class town, a lot of union members, etc., and fortunately, many of them have insurance, but I get many phone calls just as a local politician about parents who are wondering how to get their kids into drug treatment and when they tell me they don't have enough health insurance to pay for that, to say well the only way that I know of to get drug treatment and it's not a good way, but it's to get your kid arrested. And that, unfortunately, is one of the main referral mechanisms we have in our State and it would be wonderful if there was a common sense, easy access drug treatment for people who have reached that and as people -- I'm certainly not an expert on it, but people work with drug users seem to think that the moment that the willingness is there is the moment you have to take advantage of it and if you wait, it maybe too late. So, but thanks for coming in today. Are there any other questions? If not, thank you. Next is Roger Wescott. Roger Wescott. ROGER WESCOTT: My name is Roger Wescott. I am a retired professor of anthropology. My plea to you today in brief, is that we replace this interminable drug war, at least initially, with a drug truce. And my precedent here is our experience of the Vietnam War. Once it became clear to us that we were not winning the war, and that the war was probably un-winnable, we did the sensible thing, we terminated our belligerence. I think we should also recognize that history tells us something about efforts that blanket prohibition. It's not just the experience of the 1920's with alcohol prohibition with which most of us are familiar, as far back as the 16th century, a strenuous effort was made both in the Islamic world and in the Christian world to outlaw coffee. For the Moselums, it was the fact that it was an (INAUDIBLE) drink, not mentioned in the Holy Scriptures. For the Christian nations, particularly England, they felt that it was a threat to health and was perhaps a poison, but of course, coffee became so popular in both areas, that the ban had to be dropped and it was. It is a fact that every people known to anthropology has some mind altering substance that they produced themselves which they consider traditional and acceptable and necessary to good living. The only exception to this that I can think of is that of the (INAUDIBLE) eskimo of the Arctic Circle. They be the only ones that produce no drugs, but that was for a very simple reason. They had no plants from which they could extract any drugs. Now, I recognize that what will be objected almost immediately is the problem of habituation and above all, addiction. But I think when we talk about the addictiveness of drugs we are confusing substances with people. Really the proneness to addiction is a characteristic of people. It is very variable according to the individual and according to the social setting. We all know people who are addicted to sweets and fatty foods, people who are addicted to gambling and to shopping, otherwise terms like "choc-aholic" and "shop-acholic" would not be as familiar as they are. We know people who become addicted to medications, wholly legal prescribed medications, pain killers, tranquilizers and the like. What I am saying here is, following Professor Duke of Yale, that we should not militarize our drug policy, but rather medicalize it. Speaking of medicine makes me think of the founder of western medicine, Hippocrates, whose first motto was, "do no harm", but our drug war does great harm. It costs billions of dollars. It causes street shootings. It corrupts the police and judges. It overloads our courts. It overcrowds our jails. It leads to invasion of privacy, including even examples of children acting as informers on their parents in keeping with the precepts of D.A.R.E. It leads to abridgement of civil liberty and to a general atmosphere of fear and mistrust in the country. There is a also a problem, I think, of hypocrisy in the waging of the so-called "drug war". Even the phrase, "drugs and alcohol" implies, for example, that alcohol is not a drug. It certainly is and along with nicotine it is the greatest killer drug in our country compared to which marijuana and the psychedelics are relatively mild. One of the other interesting things here is that those very people who are most opposed to federal regulation of things like welfare and health care, oppose the free market in drugs. Now there are some conspicuous exceptions to this rule and I should mention decentralists like William Buckley, Milton Freedman and George Schultz all of whom are consistent with their principles and have supported the free market here. I am also troubled by the draconianism in mandatory sentencing for drug offenses. This kind of sentencing eliminates judicial discretion. It takes away from judges what is, I think, their distinctive grace, the fact that they can actually make wise and balanced decisions. All wars are destructive at best. There are no happy warriors in the drug war. Hubert Humphrey was a happy warrior as long as he was involved in the war on poverty, but when he got involved in the war of Vietnam, he ceased to be such. I recognize that a real drug peace is unlikely in the immediate future until we are at peace with ourselves and with each other. But at least let us declare a drug truce. Let us put an end to the waste and the slaughter. Thank you very much. REP. LAWLOR: Thank you, Professor Wescott. Representative Farr. REP. FARR: Can I just ask you a question? You are aware that the federal government has a new law that the new regulation that says you have to show your I.D. if you are under 27 to buy cigarettes. I assume you are against that and you are against any regulations on the sale of cigarettes? ROGER WESCOTT: No, I am not against any regulations. I think there is a difference between control and prohibition. What we now called controlled substances are actually -- REP. FARR: Well let me just -- then you are against the law that says if you are under 18, you can't -- ROGER WESCOTT: No, I'm not. I am not. I think we should control all drugs, everyone that I mentioned in both those that -- REP. FARR: But why would we have a law against it if you -- I don't understand your testimony then. You said that we ought not to be having laws against these things and now you are saying you don't want to repeal the law -- ROGER WESCOTT: When you say, "against these things" -- REP. FARR: Against drugs. You indicated that -- ROGER WESCOTT: No, I would not have laws against drugs, but I would control them and I think we can control them. REP. FARR: Okay. I am just confused. That's okay. ROGER WESCOTT: I think there is a distinction between control and prohibition and I would say that those things which we now call controlled substances are, for the most part, actually prohibited substances. And I think they should not be. But I think they should be controlled and they can be in a balanced, moderate and humane way. REP. LAWLOR: So if I understand it, you are saying that perhaps like alcohol, you have to be a certain age to get it and -- ROGER WESCOTT: Yes, I think -- REP. LAWLOR: -- you can't drive with it and you can't sell it on Sundays. ROGER WESCOTT: Yes. REP. LAWLOR: You can get -- ROGER WESCOTT: I think that should be true of all drugs. I think we have to take them individually. But I think we can do it without blanket prohibition, saying absolutely (REST OF TESTIMONY NOT RECORDED DUE TO CHANGING FROM TAPE 2B TO TAPE 3A) REP. LAWLOR: Bill Carroll? Bill Carroll? Darel Collins. DAREL COLLINS: Chairman Lawlor, members of the committee. I am 49 years old. I remember President Johnson declaring war on drugs. I remember Richard Nixon coming along and declaring the real war on drugs. And every president since then -- it's the same old story over and over again and the scene since I was a youngster in 1969-1970 I was a hippie and drugs were all over the place then and they still are, nothing has changed. But this lady right here, you should listen to her. She is really on to what the problem is here. It's a problem of how a person values themselves. If you have value for yourself you have a hedge against what that drug is going to do to you or not to do to you. If you want to save your own life you can experiment with drugs, but you say this other thing I got is better. That's what's happening in the inner city. I own a rooming house right on the edge of the fourth district here and I am looking out my window. I have been there for three years and I am watching a family with a mother -- she's got six sons, no man in the house and every year these kids are growing up and as the next one gets old enough he is going to jail and I can look out my window and I will go, okay next year this one is going to go to jail and the year after that, the other one will big enough and he will take his place. And that's what's happening right down here. Five blocks from here and I am not too worried about the two young ladies that were sitting here from the suburbs that were involved in that goody two shoes drug program that you are talking about there. I am not too worried about those young ladies, but I am worried about all these kids that I am seeing right around Frog Hollow here and they are all going to grow up with criminal records. Not only a drug problem, but a criminal record to go with it. This drug war is corrupting everybody. It's corrupting the police, it is corrupting whole nations. Look at Mexico, we can't trust anybody in Mexico anymore. But the federal government has got so much invested in this drug war that there is no way that they can declare peace, so to speak, and walk away from it. The states are going to have to take the federal government by the hand and lead them out of the wilderness and if the states can't do it, the citizens are going to have to do it. If our elected representatives aren't go to start getting a handle on this thing in leading the way, then what's happening out in California and Arizona where the people are taking the issue away from the politicians, because the politicians just have too much invested. You have huge bureaucracies built up around this drug war. People making huge livings on it. They are not going to lose their income. And so as I say, the people are going to take ballot initiatives and it is coming this way and I believe this organization that is here today with (INAUDIBLE) was involved in that and the marijuana legalization for medical purposes out there. Now the prohibition of alcohol, it started in Detroit and it ended in Detroit and what happened was when they started using children to sell and carry and deliver alcohol toward the end of Prohibition, all of a sudden the people who had started prohibition of alcohol said, wait a minute, this is going too far. When they start using children to carry the substance around, we are going to end prohibition. But evidently, former generations were more moral than we are because the drug dealers have been using a 14 year old kids outside my house down here for years because -- and I can see them, the 14 year old kid goes in the house -- I can take you right out to the window and show -- watch this happen. He goes in. He gets the dope from the guy, comes back out, gives it to car and drives away. And that s.o.b. sits in the house while the kid gets arrested for it. We have to do like they are saying. And also folks are going to say, okay, they are going to examine the treatment programs. I agree, we should go down the road away from criminalization and more toward treatment and understanding, but there are failures in treatment and you are going to compare the treatment against locking them up and this and that and saying, see this is a failure, they have been through this treatment program six times. I think what she is saying is more akin to what we -- the direction we want to go. In other words, let's declare a truce. Let's declare peace. Let's say that just because you use a substance doesn't mean that you are a bad person. You like the way it feels. She is right. Drugs do work in the inner city when there is no hope for anything and you can spend $10, get on the end of that crack pipe and have an orgasmic, euphoric 15 minutes away from your normal situation in life, you are going to do it. And it's hard to resist that when you have nothing else. It's even hard to resist it if you are a kid out in the suburbs and you do have a future ahead of you, but at least you have something to fight that high with. No one is with us -- go around the city. Rolling papers are at absolutely every convenience store. It's too late. If it was up to me, I would legalize marijuana tomorrow. And I would start looking at what we can do with heroin and cocaine, but forgive the hypocrisy and this country is absolutely amazing and marijuana is part of our culture now. If you think we are going to get rid of it, a weed that you can grow in your closet and you don't have to put it through any kind of chemical process or anything like that, if you think we are going to get rid of that, forget it. There are farmers out in Kentucky and Tennessee making their livings off of it. Now, you shut it down at the borders, it's a weed you can grow. Let's some sanity into this thing and I'm looking - this is a hopeful day for me because I own two properties in the city, but I am not going to invest another dime until I start seeing -- because the drug war is what's ruining this city and other cities like it. And as a guy who financially -- I am not going to invest any more money here until we start making some rational sense out of this. Thank you very much. I appreciate it. REP. LAWLOR: It's funny you bring up the hypocrisy topic because there was a period of time on this committee, the Judiciary Committee -- we interview all the judges and we decide whether or not we will approve the Governor's recommendation and it was like six or seven years ago there was a short period of time where every nominee was asked if they had ever smoked marijuana. And a lot of them told the truth and a lot of them didn't. And -- but a lot -- you know, it -- DAREL COLLINS: That's exactly it. REP. LAWLOR: -- and you mentioned what amount of -- DAREL COLLINS: You can't have an honest conversation about this because it is illegal and nobody can talk about it. And if you smoked marijuana for five years and it was no problem, you got bored with it and walked away from it and now you are sitting in that chair up there, that's great. But you can't talk about it. REP. LAWLOR: And these are men and women who had something else going for them in their lives -- DAREL COLLINS: Yes. REP. LAWLOR: - - and dealt with it and moved on and I am sure they wouldn't recommend it to their kids, but it was reality and theoretically they could have gone to jail. Just like Don Imus or anybody else whose -- DAREL COLLINS: My drug of preference was alcohol. In 1984 I said this substance is ruining my life. I can walk across the street and buy it legally, but it is ruining my life. I have to give it up. I didn't matter whether it was legal or illegal. It didn't matter. It was my choice in life at that time. REP. LAWLOR: Representative Farr. REP. FARR: I just want to make a quick comment where I am coming from in the question of drug use in the city because my office is in the city. I live four blocks over the line in West Hartford. And when you talk about the sale destroying the city, the use is destroying the city. I have represented a 13 year old boy in juvenile court who was reported to his psychologist that he was very hostile towards his mother. And he was hostile towards his mother because his mother and her boyfriend were living in the house with the boy and his sister and they were using drugs and there no spoons in the house because they used all the spoons to cook their drugs and at Christmas time they took the donated Christmas presents, the donated Christmas turkey and the boy's bike and they sold them for drugs. And that's the reality of what's going on in the city and it's not simply a question of who is doing the sales and drug wars, it's also the destruction that it's causing within the families of many of the residents of the cities and some of the suburban settings and that's my concern with the drug problems. DAREL COLLINS: I agree, but the fact that it's illegal exacerbates exactly what you are saying. A guy who drinks alcohol and beats up his wife, at least that can be talked about or be brought out in the open. Is a heroin a bad thing? Yes. I was around drugs all my life. I stayed right away from heroine. Walked right away because I knew what that was going to do, that that was addictive. It was an opia that once it gets a hold of you, that -- you are right, but why do they have to do that? Because it's illegal and because it costs so much. Wino's are not breaking into your car and stealing your stereo to buy wine. REP. FARR: I just point out that they are not using the drug because it is illegal. They are using drugs for whatever benefit their perceive from the use of the drugs. The question - the problem is if you say well it's illegal to use the crack or whatever they are using, then that somehow is promoting the use. I mean, there is no basis for that argument. That's just silly. That's not going to prevent it. If you say it was cheaper then they wouldn't have to sell the Christmas turkey, I suppose maybe they wouldn't sell the Christmas turkey, but believe me, there is no indication that they wouldn't be doing other irrational things. I mean, these are people that are abusing drugs and frankly, not taking care of the family. And it's the kids that are paying the price. DAREL COLLINS: Well there is going to be people who make bad choices and bad decisions. If crack cocaine was legal tomorrow, would you go out and buy it and use it? Would you? Would anyone? No. People make bad choices. SEN. HARP: You know, I just wanted to respond to something that you said about children selling drugs and I know in my community, before I was a State Senator I was on the Board of Alderman and about -- it's the same year actually that the little child was killed in the school bus because of shots trying to defend turf. In my ward, which is a small area in New Haven, at about 2:15 -- school gets out at two o'clock, this 19 year old boy was killed in the street in front of the school as the kids were getting on the school bus and I wonder in my mind like who -- what kind of a society would allow that to happen? I wonder about the trauma, not just of the family of the child who died in the street that day, but all of those children of those five buses, those 200 kids who witnessed another young person dying in the street over the sale of marijuana. And it just seems to me that a compassionate society, a sane society that wants to protect children wouldn't want to have that kind of stuff happening in its streets in front of schools and if they policies that a society has don't lead to something that stops that from happening, then we have, I believe, the wrong policies, irrespective of whether we medicalize it, or its impact. The fact that in my community three blocks from my house children are traumatized on a daily basis. They play how to sell drugs. They take from the sandbags and they put in little baggies pretend drugs. They teach each other as little kids how to sell. What kind of society develops that as an only economic option for its babies? I think we are better than that. DAREL COLLINS: And the five year olds are rolling up one pant leg outside my house down there because all the bigger ones -- that's their role model and as long as there is big money to be made in a community where otherwise there is no money, and as long as those guys come cruising down there with their 500 watt stereos and their gold hanging off their necks, the kids in my house -- I see them. They go running over to the car and boy aren't you wonderful and aren't you big. I want to be just like you. And that's what's happening. They are not looking at me, the poor struggling landlord that is trying to keep a three family house painted up and trying to keep the bureaucracies at bay and all the things. What I am doing is something achievable. These kids are either going to be a drug dealer or they are going to be an MBA basketball star, but they never thought about hey, maybe I could own a couple of houses on this street. REP. LAWLOR: Okay, if there are no other questions, thanks very much. DAREL COLLINS: Thank you. REP. LAWLOR: Mark Kinsly. Is Mark Kinsly here? Alright. MARK KINSLY: I will keep this short. One of -- it has been an interesting day. I was coming up here to see my friend, Imani and I was asked to share a few things, but while I was sitting here I was thinking about the war on drugs and I just read recently that how during the Bush administration we spent $120 billion on the war on drugs and it's been pretty effective, don't you think? REP. LAWLOR: Oh, yeah. MARK KINSLY: And you know, while I was sitting here, a lot of the topics that were brought up was about drugs in the prison systems and drugs outside. I have run the needle exchange program in Bridgeport and one of the things that is so important to me is the compassion that we need to show individuals that are out there struggling and when we talk about the drugs in the prison system and stuff like that, from my own personal experience and individuals that I deal with on a daily basis, it was easier for me to purchase drugs in prison than it is out here on the street. It may have been more expensive, but it was just as accessible and there were times when I came out of prison with a bigger habit than I went in with. But the other thing was that you know, that the compassion, the things that I see on the streets of Bridgeport on a daily basis and what Senator Harp was talking about. See, that's the stuff that keeps me going, that heartfelt stuff is seeing these young brothers and sisters out there that really, really believe. They don't think there is a different way. They believe it deep down inside that there isn't a different way. They believe it. And I talk with these young brothers and sisters every day and they, to the core of their hearts, believe they have two options. And that is to die on the street or to go to prison. That's their two options. School is not an option anymore. They are not learning in there. They are not learning in there. Some of the things that I see on the street are horrifying to me. For someone who is a recovering addict and who has been clean for years, but used drugs on the streets of up and down the east coast, for seventeen years, I am telling you it's twice as horrifying out there than it ever was. My idols were people that wore a shark skin pants and a (INAUDIBLE) shirt and that's what I grew up idolizing, okay. I never saw the violence that I see on a daily basis today. Where I grew up it was, for me, the way that I was used in this drug war is that I ran the drugs because they guaranteed that I wouldn't get pulled over because of the color of my skin and that's the truth of the matter. Nowadays I see it every day. It is so disproportionate of what is going on in the communities, especially in the communities that I serve. How come 80% of all drugs consumed in this country are by caucasians, but all the time I see the Latinos and African-Americans being locked up every day? And the Whites are coming in and buying, but they don't get arrested like these other people. It's just -- it hits me deep in my heart and I travel -- you know, I travel all over the country and I hear all this rhetoric and you know what, and I believe that most of the individuals that are doing the work that you are doing have good hearts. But you don't know what it's about out there. You don't know what it feels like. You don't know the deprivation and degradation that individuals in those situations go through. If I was living in the situations that most of the individuals that are living in the housing developments that I go to every day, you can best believe that drugs would become nothing but a necessity. It is not an option in a lot of these households. It is a survival. You have to use to deal with what's going on around you. It is horrifying. When I walk up into a housing development and the young kids have the same access to seeing a young girl, 27 years old with five bullet holes through her head because she didn't have enough for a bag of dope, there is something wrong with that. These kids are seeing this stuff. And you know what, it's cool to them because that means they are part of when they see that stuff and they walk out here and when people go out there to cop drugs, these young kids at 10, 11, 12 years old, all they do -- now they are beat down crew. It used to be when you used to go cop drugs, you were worried about the stick-up boy. Now you are not worried about the stick-up boy no more. You are worried about the 10, 11, and 12 year old kids beating you up and taking your stuff. And then selling it because that is all they see out there. I know deep in my heart that there is hope. And I believe that on a daily basis. I wouldn't continue doing what I am doing. I handled the most famous athlete in this country for four years when I was shooting dope. Addicts can perform functionally if given the opportunity. But there is a lot of -- I hear so much of what is going on. I'm grateful to my sister Imani for coming here. She has taught me a lot of stuff and I am grateful that there is a dialect going on in Connecticut. We are fortunate here. We are blessed here. And I need to commend the people who have already done some great work. Senator Harp has done tremendous work in this, you know, with needle exchange and the things that I believe strongly on. There is so much more that we can do as a state to be the leader around this country and I hope that we continue to have this and not just to talk. We need to implement some stuff because what we are doing now ain't working. It just ain't working. You know. Thank you. REP. LAWLOR: Thank you. Okay. Jay Arthur. Is Jay still here? John Kardars. JOHN KARDARS: Good afternoon. My name is John Kardars. For the record, I am an attorney and I run the criminal justice program in Bridgeport serving approximately 1,200 to 1,400 people every year, most of which are substance abusers. I have been involved in similar alternate drug policy -- alternative drug policy recommendations for the last five or six years. My interest began to peak with the exponential growth in the Department of Corrections and the ten years that I have worked for the agency I work for, I have witnessed to daylight, broad daylight shootings in Bridgeport. I have had my secretary's husband murdered and we average -- my agency, on average, loses one to two clients a month through homicide or back to the correction system for having committed a homicide almost overwhelmingly under the influence of drugs or alcohol or over drug turf. What I have noticed over the years is that I have learned about the iron law of prohibition and that is the tougher the penalties made for possession and delivering drugs, the more concentrated and more potent they become on the streets. An example, it was during prohibition, people didn't drink wine and beer, they drank gin and whiskey. In the mountains of the Andes people chew on leaves that gets converted to crack cocaine, probably the most potent direct source in the blood stream you can get. In the farms of Turkey and in Asia, most medicine contain a ball of opium which is used for folk medicine purposes. And in the countries where drinking is very much part of the culture people generally drink beer and wine and don't have the degrees of alcoholism that they do in other cultures where it is prohibited. What I've noticed is that younger people are getting involved earlier in the criminal justice system than when I was an adolescent. The people that, in many cases, there have been more -- for smaller amounts, stricter sentencing and earlier connections with the system. I also have read the Law Review Commission's recommendations and I found that probably the best well written, most thought out policy by any government body that I have -- governmental agency that I have ever read. I have seen similar recommendations coming up from non-governmental organizations from bar associations and for other think tanks that would promote such things independently, but seeing it coming from a state agency, I am very impressed with the amount of knowledge and detail that is in it and with just the same public policy recommendations. Nobody is saying drugs are good. Nobody is saying it's okay to use drugs. Nobody is putting them (INAUDIBLE) on drug use, but you also realize that there are failings and abilities of the government to control such things. The fact of the matter is that substances have been with us since the dawn of mankind and will continue to be so and that they cannot be legislated out. At one point during the Middle Ages, German soldiers smoking tobacco fields were similarly executed for using substances. That in some countries, Malaysia, for example, has a very bad drug problem, yet drug dealing is a death penalty offense there. And that we cannot legislate our way out of this mess. We cannot incarcerate our way out of the drug problem. The best way to deal with it is on a public health basis with the emphasis on treatment and education. I know I am speaking to the convinced here. I can see the panel. But nonetheless, I needed to get it on the record that sometimes science and thought move faster than politics, but there needs to be a start and Connecticut is as good a place as any to begin the process from declaring war on our citizens and our cities with all the collateral damage that entails to families and the huge race of resources that we are spending while cutting back on -- as Chairman Lawlor says, we are spending less money on higher education that we are at criminal justice and seeing how much of that is related to substance abuse. The last time I toured the Bridgeport Avenue jail, with a Deputy Warden, there was more marijuana in the air as we were walking through the cell blocks since the last Grateful Dead concert I was at. And this is with Deputy Warden in attendance with correctional officers on site. We walked into a cell block where there was no marijuana smoke. The inmates would surround us and talked with us and we walked into a cell block where there was a lot of marijuana smoke, everybody disappeared in their cells and wouldn't give us eye contact. But the fact of the matter is that no government body is able to legislate people away from using substances and that we should do what we can to make the problem more controllable, to make our system more humane, to work with what we can and there is a presence of other places in the world on this happening. And my hope is that the rest of the Legislature will catch up to what works. Thank you. REP. LAWLOR: Thank you. (INAUDIBLE - MICROPHONE NOT ON) Juliet Alberman. JULIET ALBERMAN: I am a graduate researcher at the University of Connecticut. I am about to receive my Masters degree in behavioral pharmacology and in two years I will receive my doctorate. I am a member of the Society for (INAUDIBLE) and I am also a member of the International (INAUDIBLE) Research Society. It is very unfortunate that that lady from the school drug prevention program with her two cheerleaders aren't here to listen to what I have to say because what I have to say is very important. I actually brought documentation to back up what I have to say. I brought two books with me. Both written by Doctor Lester Grenspoon of the Harvard Medical Center. One is called "Marijuana, The Forbidden Medicine". One is called, "Marijuana Reconsidered". This was written in 1971 and I think given a new introduction in 1991 and this was very recent. I am a major proponent of medical marijuana decriminalization. And I would just like to say for the record that nobody who is advocating decriminalization wants teens to have free access to marijuana. That's not the goal here and it frightens me that we lump marijuana with cocaine and heroin when we talk about these statistics. I really wish those two -- those three women were here because they were spouting off all these statistics and I really wanted to ask them where did they get this information, who did they poll, what basis do they have to substantiate the claim that if people are allowed to grow this at home for medical use that it's going to get into the hands of teenagers. I have never seen any evidence to substantiate that and the lady asked if this was worth it to decriminalize marijuana and I would say yes, it is worth it. My grandfather has prostate cancer and it costs him $200 a month to stay on the anti-nausea drugs whereas medical marijuana would be substantially less expensive and not cause as many side effects. These people who are very anti-medical marijuana or marijuana decriminalization constantly spout off statistics that no evidence exists to support the medical benefit of marijuana. I am here to show you that these two books are here. There is evidence. This is a copy of a letter that Doctor Grenspoon wrote to the Journal of the American Medical Association in 1995. In fact, begging the medical community to start speaking out in favor of medical marijuana. I have an editorial here by a researcher who was paid by NIDA to find the deleterious effects of marijuana and sadly reported that he could find none, yet all this anti-drug or anti-marijuana literature claims -- like he wrote here, exaggerated claims concerning adverse side effects, but there is no information or there are no studies to back this claim. No actual research was actually mentioned in these pamphlets. That was my point for coming here today. I am really sorry that the audience that probably could have benefitted most from what I had to say or what I had to show them is not here, but I followed her out after she left and gave her a copy of the letter by Dr. Grenspoon. Everybody here today has very eloquently stated that the drug policy is not working. I think we just need to change our attitude about drugs, not lump all drugs together, in particular, medical marijuana. I just think that the benefits are obvious and people are ignoring them and I don't know if it is that you are not getting the information that I can find by looking in these medical journals or you know, you didn't know it was there or a woman like that doesn't know it's out there. I can't understand how these people can claim that no evidence exists to support these claims. I got this in in a Border's Book Store, you know. That's out there. So, I just wanted to say that for the record. SEN. HARP: Can I ask you a question? JULIET ALBERMAN: Sure. SEN. HARP: So in terms of marijuana being a carcinogen then, can you tell me a little bit about that? JULIET ALBERMAN: Yes. SEN. HARP: Could you compare it to tobacco, for example? JULIET ALBERMAN: Okay. Marijuana is a carcinogen. Nothing is a panacea, okay. We thought that Eldopo was the cure for Parkinson's 40 years ago. It has since proven not be so effective. Marijuana is not one hundred percent good for you. It can be consumed to excess and there are people who abuse it and I don't think that anybody who is a medical marijuana proponent would deny that. The evidence that I have seen has shown that if you are allowed to consume a very potent form of Delta 9THC, the active component of the plant, you have to smoke less and it causes less alveolar damage to the lungs. People who smoke tobacco tend to smoke constantly throughout the day. A pack a day habit, I guess, is average for American smokers. People who smoke marijuana for medical benefit usually have to take four doses per day. That's one inhalation four times a day. So the number of pack years as Doctor Grenspoon talks about in this book is substantially lower than people who smoke tobacco. People who smoke tobacco in combination with marijuana are, unfortunately, the worst off. But I think if people are allowed to grow very potent forms of the drug, evidence has shown that people will consume that which they need. You can't overdose on marijuana. It doesn't kill brain cells. And there is not one single documented case of a marijuana overdose and a marijuana death. People do use it in combination with other very dangerous drugs, but alone it can cause lung cancer, but the evidence shows that people will consume as little as they have to get the desired effect. It is a carcinogen, though. I mean -- but it has to be consumed to a much greater extent than the average person who needs it for medical use would consume it. SEN. HARP: Have there been any studies? Because one of the things that the lady whose name I forgot -- Ms. Patrick, I guess, talked about was it being a feeder drug. Is it anymore of a feeder drug than say cigarettes? JULIET ALBERMAN: Okay. I just recently - I wish to God I had brought that here because I heard -- are you talking about the Gateway Drug Theory? Okay. I just recently read a report by a Dutch researcher who did a very extensive study of heroin addicts in I think it was Holland and Denmark -- European countries because unfortunately American researchers don't get federal funding to drug studies unless they are going to show bad things. He showed that 75% of people who were addicted to heroin had at one time in their life, used marijuana. But 90% of those people had used alcohol at one time in their life prior to heroin. Now, perhaps using alcohol is different because it is legal. You don't have to go through the illegal means -- you know, by which to get marijuana and maybe that's how some people who use marijuana and then sort of graduate to higher drugs like cocaine and heroin, it introduces them to people who can get that for them. So in that aspect it may be a gateway drug, but I have seen very little evidence to substantiate that. Most drug addicts that seek rehabilitation or treatment are poli-drug users and they may at one time have reported that they have used marijuana, but they have also reported that they have used tobacco and alcohol. So I don't really understand why we are not calling alcohol a gateway drug, but we call marijuana a gateway drug. I have never understood that. There's very little evidence to support that. SEN. HARP: Thank you. JULIET ALBERMAN: You are welcome. REP. SCALETTAR: Actually, I would take that one step further. I always wonder about that whole theory the way it's constructed because it seems to me you could probably say 100% of those people started out on milk. JULIET ALBERMAN: Exactly. REP. SCALETTAR: Milk is the gateway. JULIET ALBERMAN: Milk is the gateway drug. REP. SCALETTAR: The more significant statistic, I would think is to say well how many people who use marijuana go on to use other drugs or how many people who use tobacco or who use alcohol, but that whole concept, I think, is -- I am not a statistician, but I think the common sense tells me that the whole approach is wrong. JULIET ALBERMAN: Right. REP. SCALETTAR: So I think you could probably refute it in even stronger terms. JULIET ALBERMAN: Right. I am going to the International (INAUDIBLE) Research Society conference in June. It will be my first time attending the conference and I know that that's probably one of the things that we will talk about is how do we refute or provide solid evidence in reputable medical journals that refutes this whole gateway theory? Because I believe that -- it takes a long time to find studies that do not substantiate that claim, but in order for us to come forth or come in front of you and tell you that that's the truth, we need -- you know, we need good scientific studies. I hope that -- I guess Bill Clinton just -- I don't know, through which organization, but donated a $1 million to the National Academy of Science to do a thorough literature review of the evidence that exists to support medical marijuana and the evidence, I guess, that's -- you know, that shows its substantiates it adverse affects and hopefully, you know, that information will be more readily available or you know, people will not have to dig like I have had to do. It's hard to find the research that supports what we all know to be true of for what some of us know to be true. REP. LAWLOR: And something tells me that the fact that medical marijuana may be a carcinogen is not such a big deal to people who are using it to counteract the side affects of chemotherapy because they have cancer. JULIET ALBERMAN: That's exactly right and the AIDS wasting syndrome. That's exactly right. REP. LAWLOR: Okay. Thanks very much. Thanks for waiting. And you know, that hearing is going to be on March 20th, next Thursday. SEN. HARP: We are having a hearing on medical marijuana use on March 20th. JULIET ALBERMAN: I am sorry? SEN. HARP: The Public Health Committee is having a hearing on the medical use of marijuana on March 20th. It would be nice if you would come. JULIET ALBERMAN: Oh, I would love to come. What day of the week is that? REP. LAWLOR: Thursday. (Whereupon, the public hearing was adjourned.)