Director's Report to the National Advisory Council on Drug Abuse
(Prepared April 11, 2001)
FISCAL 2002 BUDGET
Before Congress adjourned for its 2-week Spring recess on April 7, 2001, the House passed its FY 2002 budget resolution (H. Con. Res. 83). The Senate, in a series of votes on the measure, added billions for higher spending. On a key vote prior to passage, the Senate shifted $450 billion from the budget resolution's tax-cut allocation to education and debt reduction. For health, the budget resolution assumes $41 billion for discretionary health, which is $2.2 billion above last year's spending level. At the same time, the budget includes a $2.8 billion increase for NIH.
President Bush released his detailed budget proposal on Monday, April 9, 2001. The $1.96 trillion budget for fiscal 2002 would hold discretionary spending to a 4 percent increase overall. The President's top domestic priorities, education and defense, would get the biggest boosts. Those increases would be offset by reductions in other areas, including environmental and natural resources programs, agriculture and transportation. The Administration has indicated that the President may veto appropriations bills exceeding his 4 percent target.
The President's budget reflects the Administration's commitment to continue the five-year plan to double the NIH budget by FY 2003, with FY 2002 representing the fourth installment of this plan. NIH would get the biggest discretionary spending increase ever, with a boost of $2.8 billion to a total of $23.1 billion - a 13.5% increase over FY 2001. Of that amount, $12.5 billion, a 12.6% increase, would be spent on research project grants to fund 9,158 new and competing grants. Support for AIDS research would increase by $258 million, or 11.5%. NIDA would receive $907,369,000 in FY 2002, for a 16.2% increase over 2001.
January 29, 2001 - At the request of staff of the Senate Judiciary Committee, Dr. Alan I. Leshner, briefed a bipartisan group of Committee staff. The focus of the meeting was on research relating to drug abuse treatment programs in the criminal justice system and aftercare components. Mary Mayhew and Keith Van Wagner, OSPC, accompanied Dr. Leshner.
March 15, 2001 - Dr. Alan I. Leshner briefed Rep. Ralph Regula (R-OH), Chairman, House Appropriations Subcommittee on Labor HHS/Education, and his staff on the current state of drug abuse treatment and prevention research. Of particular interest to the Chairman was the development of the Clinical Trials Network. Mary Mayhew, OSPC, accompanied Dr. Leshner.
March 21, 2001 - At the request of Rep. C.W. 'Bill' Young (R-FL), Chairman, House Appropriations Committee, Dr. Alan I. Leshner, briefed the Chairman and his staff on a wide-range of drug abuse issues. Specifically, Dr. Leshner discussed the Clinical Trials Network, emerging drug trends in Florida, and prescription drug abuse among the elderly. Mary Mayhew, OSPC, accompanied Dr. Leshner.
March 22, 2001 - At the request of Senator Orrin Hatch (R-UT), Chairman of the Senate Judiciary Committee, Dr. Alan Leshner met with the Committee's Majority Staff Director to follow-up on key issues related to the March 14, 2001, Senate Judiciary Committee hearing on "Treatment, Education and Prevention: Adding to the Arsenal in the War on Drugs". Mary Mayhew, OSPC, accompanied Dr. Leshner.
Senate Judiciary Committee Hearing - March 14, 2001
Dr. Leshner was invited to testify before the Senate Judiciary Committee at a hearing on "Treatment, Education, and Prevention: Adding to the Arsenal in the War on Drugs." The hearing focused on the need for a comprehensive strategy to combat the national problem of addiction. Witnesses included representatives from the Drug Enforcement Administration, the U.S. Attorney's office, as well as state organizations, advocacy groups and private citizens.
In his statement before the Committee, Dr. Leshner stressed the importance of drug treatment and prevention research. He pointed out that numerous studies have shown that addiction treatments are just as effective as those for other illnesses. For example, one very important analysis recently published in the Journal of the American Medical Association (JAMA, October 4, 2000) clearly shows that addiction treatments work just as well as treatments for other chronic, relapsing illnesses such as asthma, hypertension, and diabetes. He testified that scientific discoveries are fueling the development of more successful strategies to deal with addicted criminal offenders. The core phenomenon is that untreated addicted offenders have extremely high rates of post-release recidivism both to drug use and to criminality. However, providing science-based treatments while offenders are under criminal justice control can dramatically reduce recidivism, again both to drug use and to later crime. He went on to say that, understanding addiction as a treatable, chronic illness has beneficial ramifications for our national drug control efforts. In answering questions about jail-based substance abuse treatment, Dr. Leshner said it is important that we not settle for "just anything called treatment," but rather focus on programs that are comprehensive and science-based.
Senate Caucus on International Narcotics Control Hearing - March 21, 2001
The Senate Caucus on International Narcotics Control, co-chaired by Sen. Charles Grassley (R-IA) and Sen. Joseph Biden (D-DE), held a hearing on "America at Risk: The Ecstasy Threat". In their opening statements, the co-chairmen spoke of the importance of educating America's youth on MDMA. Sen. Grassley complimented the work of NIDA in trying to further our understanding of the drug, while Sen. Graham (D-FL) touched upon expanding research that explains how Ecstasy disrupts serotonin levels in the brain. During the hearing the Senators explored with the witnesses methods by which to control MDMA's use and educate potential users as to its dangers. Testifying at the hearing were representatives from the Office of National Drug Control Policy, the Drug Enforcement Administration, U.S. Customs and state and local law enforcement agencies.
House Government Reform Subcommittee on Criminal Justice, Drug Policy and Human Resources Hearing - March 27, 2001
The House Government Reform Subcommittee on Criminal Justice, Drug Policy and Human Resources held a hearing on "'Medical' Marijuana, Federal Drug Law and the Constitution's Supremacy Clause". The Subcommittee, chaired by Rep. Mark Souder (R-IN), heard testimony from groups for the legalization of marijuana for medicinal purposes, and those opposed. In addition, witnesses from the Drug Enforcement Administration and the Institute of Medicine testified.
House Appropriations Subcommittee on Labor/HHS/Ed will hold NIH hearings May 16, 2001
The Committee on Appropriations, Subcommittee on Labor, HHS, and Education will hold the "NIH Budget Overview" hearing on May 16, 2001. Dr. Ruth Kirschstein, Acting Director, will testify. Dr. Alan I. Leshner, Director, NIDA, and other Institute/Center Directors will accompany Dr. Kirschstein.
BILLS OF INTEREST
S. 89 - Drug-Free America Act of 2001 - Sen. Charles Grassley (R-IA) introduced S. 89 on January 22, 2001, a bill that primarily is designed to enhance the illegal narcotics control activities of the US, including provisions relating to enhancing inspection and drug interdiction capabilities of the Customs Service and the National Guard. The bill also authorizes NIDA's Clinical Trials Network to conduct its large-scale treatment studies in community settings. Under the proposed legislation, the authorization would be through Fiscal Year 2007. The bill also includes a 'sense of the Senate' section that encourages NIH to work with experts from private industry to promote research regarding pharmacological options that may be employed to support drug treatment efforts. The bill would also increase the number of residential drug abuse treatment units in Federal prisons and compel the Secretary of HHS to award grants in establishing adolescent therapeutic community treatment programs. In addition, it would have grants made by ONDCP to establish the National Community Anti-Drug Coalition, funding up to two million dollars in Fiscal Year 2002. S. 89 was referred to the Senate Judiciary Committee.
S. 160 - Drug Abuse Treatment on Demand Assistance Act - Sen. Barbara Boxer (D-CA) introduced S. 160 on January 23, 2001. The bill would authorize appropriations for grants for the purpose of increasing the maximum number of individuals to whom public and nonprofit private entities are capable of providing effective treatment for substance abuse, with the goal of ensuring that substance abuse treatment is available for all who seek it. It would set up state grant programs to support: the construction of treatment facilities; payments to treatment centers; drug testing; and counseling, including mental health services. Among the programs proposed under the bill, several would provide substance abuse treatment to convicted criminals. S. 160 would authorize $600 million annually from Fiscal Year 2002 through 2006. States would be required to match the money with non-federal contributions. S. 160 was referred to the Senate Health, Education, Labor and Pensions Committee.
S. 304 - Drug Abuse Education, Prevention and Treatment Act of 2001 - Citing the need for a more balanced approach to the war on drugs, a bipartisan group of senators introduced S. 304 on February 13, 2001. Sen. Orrin Hatch (R-UT) and four co-sponsors (2 Republican, 2 Democrat) introduced the bill to reduce illegal drug use and trafficking and to help provide appropriate drug education, prevention, and treatment programs. Along with provisions that would increase penalties for drug-related offenses involving juveniles and reestablish drug courts, S. 304 allows for drug-free prison incentive grants for the creation and expansion of substance abuse treatment programs in correctional settings. Included in the bill is language that encourages an aftercare component in the treatment of prisoners for drug abuse and addiction. Section 308 calls for the expansion of drug abuse prevention and treatment research at NIDA and authorizes an appropriation of $76.4 million for that purpose. The bill also provides for the development of additional school and community-based drug education and prevention programs that are 'researched-based'. In addition, S. 304 contains a section that would include religious organizations as Non-Governmental Organizations that should be considered to provide assistance on the same basis as other such organizations. Upon its introduction, S. 304 was referred to the Senate Committee on the Judiciary.
S. 595 - Fairness in Treatment: The Drug and Alcohol Addiction Recovery Act of 2001 - A bill to amend the PHS Act, Employee Retirement Income Security Act of 1974, and the IRS Code of 1986 to provide for nondiscriminatory coverage for substance abuse treatment services under private group and individual health coverage was introduced by Sen. Paul Wellstone (D-MN) on March 22, 2001. S. 595 was referred to the Committee on Health, Education, Labor and Pensions.
Amendment Number 186 to H.C. Res. 83 - On April 4, 2001, the Senate passed the Specter-Harkin amendment to H.C. Res. 83 by a vote of 96 to 4. This legislation amends the FY 2002 budget resolution to increase the assumption for NIH within the function 550 total by $700 million. This would put NIH on the doubling track in 5 years, with a $3.5 billion increase in FY 2002. H.C. Res. 83 originally assumed a $2.8 billion increase for NIH, consistent with the President's request. The amendment was co-sponsored by Senators Mikulski (D-MD), Collins (R-ME), Landrieu (D-LA), Kerry (D-MA), Wellstone (D-MN), Murray (D-WA), DeWine (R-OH), Sarbanes (D-MD), and Snowe (R-ME).
S. 723 - Stem Cell Research Act of 2001 - On April 5, 2001, Sen. Arlen Specter (R-PA) Chairman, Appropriations Subcommittee on Labor, HHS, Education, introduced S. 723, a bill to amend the PHS Act to provide for human embryonic stem cell generation (derivation) and research. The bill had 12 cosponsors. S. 723 was referred to the Committee on Health, Education, Labor and Pensions.
H.R. 162 - Mental Health and Substance Abuse Parity Amendments of 2001 - Introduced by Rep. Marge Roukema (R-NJ) on January 3, 2001, H.R. 162 is identical to legislation sponsored in the 106th Congress by the Representative. The bill would amend the Public Health Service Act, Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to prohibit group and individual health plans from imposing treatment limitations or financial requirements on the coverage of mental health benefits and on the coverage of substance abuse and chemical dependency benefits if similar limitations or requirements are not imposed on medical and surgical benefits. H.R. 162 has been referred to the House Education and the Workforce, the House Energy and Commerce, and the House Ways and Means committees. It currently has 91 co-sponsors (79 Democrats, 11 Republicans, and 1 Independent).
H.R. 1167 - Comprehensive Tuberculosis Elimination Act of 2001 - A bill to amend the Public Health Service Act with respect to making progress toward the goal of eliminating tuberculosis, was introduced by Rep. Sherrod Brown (D-OH). H.R. 1167 was referred to the Committee on Energy and Commerce.
H.R. 1185 - Global Access to HIV/AIDS Medicines Act of 2001 - A bill to prohibit the revocation or revision of any intellectual property or competition law or policy of a developing country that regulates HIV/AIDS pharmaceuticals or medical technologies. Introduced March 22, 2001 by Rep. Barbara Lee (D-CA), H.R. 1185 was referred to Energy and Commerce and Judiciary Committees.
H.R. 1194 - Harold Hughes-Bill Emerson Substance Abuse Treatment Parity Act of 2001 - Introduced March 22, 2001 by Rep. Ramstad (R-MN). A bill to amend the Employee Retirement Income Security Act of 1974, Public Health Service Act, and the Internal Revenue Code of 1986 to provide parity with respect to substance abuse treatment benefits under group health plans and health insurance coverage. H.R. 1194 was referred to the Committee on Education and the Workforce, House Energy and Commerce, House Ways and Means.
H.R. 1260 - Ban on Human Cloning Act - On March 28, 2001, Rep. Kerns (R-IN) introduced H.R. 1260, which was referred to the Judiciary Committee.
H.R. 1340 - Biomedical Research Assistance Voluntary Option Act - On April 3, 2001, Rep. Bilirakis (R-FL) introduced H.R. 1340, a bill to amend the IRS Code of 1986 to allow taxpayers to designate that part or all of any income tax refund be paid over for use in biomedical research conducted through NIH. H.R. 1340 was referred to the Committees on Ways and Means and Energy and Commerce.
H.R. 1454 - A bill to prohibit the importation of bidi cigarettes - On April 4, 2001, Rep. Gallegly (R-CA) introduced H.R. 1454. The bill cites the economic and health related reasons for the legislation. For example, it states that 430,000 people die every year from tobacco use; medical expenses from treating smoking-related diseases cost the U.S. economy $89,000,000,000 annually; studies indicate that bidi cigarettes manufactured with flavors, such as strawberry, chocolate, and mandarin orange, are more likely to induce children to smoke; and that bidi cigarettes are more likely to be sold illegally to youth and without required warning labels; because of similar appearance to marijuana cigarettes, bidi cigarettes are considered to be a more likely "gateway drug", and could lead to more children using illegal drugs; and bidi cigarettes generally deliver 3 to 8 times more nicotine, 3 times more carbon monoxide and 5 times more tar, as well as higher levels of phenol, ammonia, nitrosamines, and hydrogen cyanide, than conventional U.S. filtered cigarettes. H.R. 1454 was referred to the Committee on Ways and Means.
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