S. HRG. 109–248 METHAMPHETAMINE ABUSE HEARING BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE ONE HUNDRED NINTH CONGRESS FIRST SESSION SPECIAL HEARING APRIL 21, 2005—WASHINGTON, DC Printed for the use of the Committee on Appropriations ( Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html U.S. GOVERNMENT PRINTING OFFICE 22–285 PDF WASHINGTON : 2006 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 COMMITTEE ON APPROPRIATIONS THAD COCHRAN, Mississippi, Chairman TED STEVENS, Alaska ROBERT C. BYRD, West Virginia ARLEN SPECTER, Pennsylvania DANIEL K. INOUYE, Hawaii PETE V. DOMENICI, New Mexico PATRICK J. LEAHY, Vermont CHRISTOPHER S. BOND, Missouri TOM HARKIN, Iowa MITCH MCCONNELL, Kentucky BARBARA A. MIKULSKI, Maryland CONRAD BURNS, Montana HARRY REID, Nevada RICHARD C. SHELBY, Alabama HERB KOHL, Wisconsin JUDD GREGG, New Hampshire PATTY MURRAY, Washington ROBERT F. BENNETT, Utah BYRON L. DORGAN, North Dakota LARRY CRAIG, Idaho DIANNE FEINSTEIN, California KAY BAILEY HUTCHISON, Texas RICHARD J. DURBIN, Illinois MIKE DEWINE, Ohio TIM JOHNSON, South Dakota SAM BROWNBACK, Kansas MARY L. LANDRIEU, Louisiana WAYNE ALLARD, Colorado J. KEITH KENNEDY, Staff Director TERRENCE E. SAUVAIN, Minority Staff Director SUBCOMMITTEE ON DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES ARLEN SPECTER, Pennsylvania, Chairman THAD COCHRAN, Mississippi TOM HARKIN, Iowa JUDD GREGG, New Hampshire DANIEL K. INOUYE, Hawaii LARRY CRAIG, Idaho HARRY REID, Nevada KAY BAILEY HUTCHISON, Texas HERB KOHL, Wisconsin TED STEVENS, Alaska PATTY MURRAY, Washington MIKE DEWINE, Ohio MARY L. LANDRIEU, Louisiana RICHARD C. SHELBY, Alabama RICHARD J. DURBIN, Illinois ROBERT C. BYRD, West Virginia (Ex officio) Professional Staff BETTILOU TAYLOR JIM SOURWINE MARK LAISCH SUDIP SHRIKANT PARIKH CANDICE ROGERS ELLEN MURRAY (Minority) ERIK FATEMI (Minority) ADRIENNE HALLETT (Minority) Administrative Support RACHEL JONES (II) CONTENTS Page Opening statement of Senator Tom Harkin .......................................................... 1 Opening statement of Senator Harry Reid ............................................................ 2 Prepared statement .......................................................................................... 3 Statement of Charles G. Curie, Administrator, Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services ................................................................................................... 4 Prepared statement .......................................................................................... 6 Statement of Nora D. Volkow, M.D., Director, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services ................................................................................................................. 11 Prepared statement .......................................................................................... 13 Statement of Vicki Sickels, Des Moines, Iowa ...................................................... 18 Statement of Richard E. Steinberg, president and chief executive officer, Westcare Foundation, Inc., and president, Therapeutic Communities of America ................................................................................................................. 21 Prepared statement .......................................................................................... 23 Additional statements: Prepared statement of the Community Anti-Drug Coalitions of America ... 42 Prepared statement of the National Association of State Alcohol and Drug abuse Directors, Inc. ........................................................................... 45 Prepared statement of the Heartland Family Service, Inc. .......................... 51 Prepared statement of the Legal Action Center ............................................ 54 Prepared statement of the Therapeutic Communities of America ............... 58 (III) METHAMPHETAMINE ABUSE THURSDAY, APRIL 21, 2005 U.S. SENATE, SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES, COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:33 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Tom Harkin presiding. Present: Senators Harkin and Reid. OPENING STATEMENT OF SENATOR TOM HARKIN Senator HARKIN. The hearing of the Labor, Health and Human Services Appropriations Subcommittee will now come to order. Our topic this morning is methamphetamine abuse, but before I read my opening statement I first just want to again publicly thank the chairman of this subcommittee, Senator Arlen Specter of Pennsyl- vania, for the great working relationship that we have always had. As he has pointed out, this gavel has changed back and forth four or five times since we have been on the subcommittee, and it al- ways has, to use his words, been a seamless transfer of the gavel. I think it is a mark of his great leadership that he allows me to chair a hearing here on methamphetamine or other things that I ask to chair hearings on. Likewise, when I was chairman I allowed him to have hearings, as I did for people when I chaired the Agri- culture Committee. I think that is really the way the Senate ought to operate. These are nonpartisan issues that we are talking about here, and we are very busy people. Sometimes I have the interest in a certain area or the time to do something and then sometimes Senator Specter has the interest and the time and I do not. So this is a way in which we I think are better able to collect the kind of information and data that we need to make informed decisions. So I wanted to publicly again thank my chairman and my friend Senator Specter for allowing us to have this hearing. As I said, our topic this morning is methamphetamine abuse. I am sad to say this, but my home State has been hit particularly hard by this epidemic. Iowa ranks fourth among all States in the percentage of residents who are admitted to treatment centers be- cause of meth. That is not a statistic that we are happy about. Fortunately, Iowa is responding. The State recently passed the toughest law in the Nation for limiting consumer access to pseudoephedrine, one of the key ingredients for making meth. Thanks to grants from SAMHSA, the Iowa Department of Public Health is pioneering innovative strategies for preventing and treat- (1) 2 ing meth abuse. Des Moines is one of five sites participating in NIDA’s methamphetamine clinical trials group, studying the use of medication and group therapy in meth treatment. But Iowa is not alone in struggling with meth abuse. There are 16 States that now have higher treatment admission rates for meth than for cocaine and heroin. Recently we have heard disturbing re- ports that meth is moving to big cities on the East Coast, where the drug has been linked to the spread of HIV. Certainly law enforcement has a critical role to play in curbing meth abuse. I strongly support efforts to crack down on the people who are making and selling this drug. But even if we shut down every home-based lab and threw every dealer into jail, we would still have a meth problem in this country. It will not go away until we do a better job of preventing people from using meth in the first place and giving addicts the treatment they need to kick the habit for good. That is where this hearing comes in. SAMHSA and NIDA, two agencies funded in our bill, are our most important Federal re- sources for preventing meth abuse. We have to make sure they get the appropriation levels they need to address the problem. Meth is destroying lives, filling our prisons, and taking mothers away from their children, and we need to stop this epidemic now. We are fortunate to have an outstanding panel of witnesses to discuss this issue with us this morning, and I will introduce them all shortly after I recognize our distinguished leader here. But I want to offer a special welcome to Vicki Sickels from Des Moines, who will give us a firsthand account of what it is like to struggle with an addiction to meth. So, Vicki, I want to publicly again thank you for taking time to come here today and tell your story. You are really what this hearing is all about. With that, I will turn to my good friend and our distinguished leader on our side, Senator Reid from Nevada. OPENING STATEMENT OF SENATOR HARRY REID Senator REID. Senator Harkin, thank you. Thank you very much. There is so much ill will and partisanship in this body that I am obligated to say how fortunate we are to have two people work as closely together as you and Arlen Specter. I want everyone in this audience and on this panel to understand what a rare situation we have here. Senator Harkin is the ranking member. He is not the Chair of this subcommittee. But he and Senator Specter have been Chair and ranking member as the majority goes back and forth in this body and they consider each other equals. Here, in spite of all the partisanship in this body, Senator Harkin is conducting this hearing. I think it speaks so well of you and Senator Specter. Senator HARKIN. Thank you. Senator REID. I do appreciate your holding this hearing. I would ask that my full statement be made part of the record. Senator HARKIN. Without objection.