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Originally Processed With FOIA(s): foia Number: S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: George H.W. Bush Presidential Records Collection/Office of Origin: Speechwriting, White House Office of Series: Davis, Mark, Files Subseries: Subject File, 1989-1991 OA/ID Number: 13873 Folder ID Number: 13873-008 Folder Title: National Conference of State Legislators, 3/10/89[2] Stack: Row: Section: Shelf: Position: G 19 2 6 6 National Conference of State Legislatures A Guide to Programs and Services NORTH DAKOTA RHODE ISLAND ALASKA NEVADA OREGON MAINE IDAHO WHAT NCSL IS The National Conference of State Legis- Researching legislators' questions about Encouraging the exchange of informa- latures is a non-partisan organization creat- hundreds of problems from AIDS to tax- tion among states on policy issues as well ed to serve the legislators and staffs of the ation, pollution to child welfare; as the internal management of the legisla- nation's 50 states, its commonwealths and Representing the states' interests before ture itself; and territories. NCSL provides research, tech- the Congress and federal agencies, and Providing the opportunity for legislators nical assistance, and the opportunity for analyzing the effects of federal actions on and staff to meet, study issues and develop policymakers to exchange ideas on the the states; policy recommendations through the most pressing state issues. NCSL also is an Assembly on the Legislature and the State- effective and respected representative for Federal Assembly. the interests of state governments before NCSL's Denver office offers state legis- Congress and federal agencies. lators and staff information and research The dramatic shift of power from Wash- on issues particularly appropriate to state ington, D.C. to the states has increased the government action; the Washington, D.C. scope of responsibilities confronting state office concentrates on lobbying for state legislatures. Lawmakers want to know how interests and tracking federal government to shape policies that will work for their actions that affect the states. states and constituents. For 14 years, the Appropriations from the individual legis- National Conference of State Legislatures latures provide NCSL's main funding, but has served lawmakers and their staffs by: federal agencies and private foundations (including the Foundation for State Legis- Helping individual legislators become latures) provide financial help for specific more expert in their areas of interest, and projects. therefore more effective lawmakers; Giving legislators and their staffs a chance to learn about creative solutions to and the latest thinking on the tough problems of the day; Offering training for legislative leaders in management, policy development and intergovernmental relations; Offering training for both new and experienced legislative staff members in computer use, bill drafting, budget development and research; PENNSYLVANIA MARYLAND MISSOURI TENNESSEE MISSISSIPPI MONTANA WHAT NCSL PROVIDES Information and Assistance documents, journal articles, 50-state sur- programs, plus issue briefs, budget briefs Special Services for Leaders veys and statistical data in spreadsheet and special analyses of the impact on the Meetings and Seminars format, research reports, and research cur- states of developments (such as Gramm- Congressional Lobbying rently under way. LEGISNET is a free, com- Rudman-Hollings) that are not themselves Publications puterized research data base available to all grants in aid. Special Services for Staff state legislators and their staff, who may Videos query the system by means of terminals in Special Services for Leaders their own offices; or on request, NCSL staff Managing a legislative body is a challenge Information and Assistance in the best of circumstances, and NCSL is Along with general information about there to help leaders meet that challenge. the issues confronting them, legislators NCSL conducts a Symposium for New need to know what other states and the Leaders every two years in January, where federal government are doing in any given participants discuss managing the legisla- policy area. Last year NCSL answered more tive process, policy development and than 12,000 requests for information and intergovernmental relations. Every January made numerous on-site trips to assist states in Washington at the annual Leader to in solving policy problems. Leader meeting, state legislative leaders get The Conference tailors its assistance to together with congressional leaders, cabi- the needs of an individual legislature. This net officers and key administration officials may mean sending skilled professional to exchange views on pressing state-federal NCSL staff to work directly with law- issues. makers or legislative staffers, making The Conference also provides leaders an arrangements for expert witnesses to tes- opportunity for informal roundtable dis- tify before a legislative committee, con- will do the searching. Requests for infor- cussions twice a year. Leaders receive ducting special workshops on a topic mation not found in LEGISNET often lead several publications that provide timely confronting a legislature, conducting need- to new research or 50-state surveys. NCSL policy information, including the monthly ed training programs for legislators and staff members answer more than 12,000 Leaders' Letter, a directory of leaders in staff, or responding to an individual legis- requests for information each year. other states, a guide to legislative leader- lator's request for information. NCSL and the National Governors' ship, and all State Legislative Reports NCSL can provide, through its LEGIS- Association jointly manage a computerized covering legislative management and NET system, abstracts of thousands of service providing detailed information and procedures. legislative research reports, public policy projections on about 90 percent of the At the request of legislative leaders, federal funds going to each state, called NCSL conducts thorough studies of Federal Funds Information for States procedural issues, rules reform, budget (FFIS). FFIS is offered on a subscription procedures and information systems, and basis. Subscribers receive reports three arranges workshops to link veteran leaders times a year tracking the allocations for willing to share their experience with each state in more than 240 grant-in-aid others. NEW HAMPSHIRE WASHINGTON MINNESOTA MICHIGAN ARIZONA KANSAS Special Services for Staff sional staff members get together at NCSL's with letters and phone calls to federal NCSL offers a wealth of learning and Annual Meeting, five days jampacked with officials. professional development opportunities informative sessions and nationally known for legislative staffers, whether new or speakers on current issues confronting the Publications experienced. The secrets of such skills as states. Ten times a year, NCSL publishes State computer use, bill drafting, legal research, Legislatures magazine. Like the organiza- and press relations are all examined in State-Federal Relations tion's numerous other publications, this regular and special staff workshops, held NCSL's state-federal relations effort is national magazine of state government and the year round. policy is sent free of charge to all legisla- NCSL conducts an annual seminar to Regulatio tors and their staff members, and is for sale help staff directors and supervisors Child to the general public. Conference Report, improve their management skills, and Enforcem a quarterly newsletter, describes the activi- another to help new staff people sharpen ties of NCSL members and staff. Federal their skills in research, program evaluation, Update, published 15 times a year, informs fiscal analysis, bill drafting and other legis- legislators and staff about federal legisla- lative procedures. tion, executive regulations, court decisions Staff members can get together and share and other federal matters that concern the common problems and information in one states. of NCSL's nine professional staff organiza- NCSL offers a great many specialized tions for legislative clerks and secretaries, publications, from books to brief sum- computer users, leadership staff, legal maries of developments to thorough services staff, research librarians, program studies of a number of policy areas. State evaluators, fiscal officers, security person- Legislative Reports, which focus on current nel and researchers. issues, are published 12 to 18 times a year. designed to take maximum advantage of its State-Federal Issue Briefs are written about Meetings and Seminars principal assets in lobbying-the political 30 times a year. All are available to legisla- Legislators and staff have dozens of link between state lawmakers and mem- tors on request. Ask the Marketing Depart- opportunities a year to attend NCSL meet- bers of Congress, and the information the ment in the Denver office for the current ings on subjects as varied as the drug Conference develops on state approaches publications catalog. problem, economic development, long- to issues. Members of the State-Federal term health care, water allocation, minori- Assembly and other legislators testify regu- Videos ty education, state tax policy, telecom- larly before Congress on a variety of issues. With the aid of the Foundation for State munications and asbestos safety. These State legislators frequently meet in Wash- Legislatures, NCSL has produced a number meetings are announced six to eight weeks ington with their congressmen and mem- of timely, short videotapes. They are avail- ahead of time in the Conference Calendar bers of the administration to voice NCSL's able free to legislators and staff on two- and other NCSL publications. concern about federal issues. And each week loan, and can be rented or purchased And in late July or early August every year, hundreds of state legislators respond by others. See the listing in the current pub- year, thousands of legislators and profes- to appeals through NCSL Action Alerts lications catalog. SOUTH dakota NEW MEXICO COLORADO LOUISIANA VIRGINIA DELAWARE HOW IT WORKS The organization is governed by seven smoking? legislative staff salaries? waste major forum for the exchange of ideas and officers who are members of a 54-member recycling? etc., etc.). They also plan and information among state legislatures. executive committee elected yearly and provide help of various kinds to legisla- Working through several standing commit- composed of legislators and staff members. tures, and frequently produce special tees on a set of topics ranging from arts and For information on nearly any subject, publications. tourism through economic development all it takes is a phone call to either the In addition, at least one person on the and fiscal matters to science and technol- Denver or the Washington, D.C. office to NCSL staff is assigned to each state to serve ogy, AOL members (appointed for two- get in touch with an NCSL research staff year terms) meet three times a year, twice member assigned to one of several general LEGISNET in selected state capitals and once at the subject areas- Annual Meeting in the summer. The issues to be dealt with are chosen by the commit- Agriculture and energy; arts, tourism and tee members. cultural resources; education, labor and job Like the AOL, the State-Federal Assembly training; environment, science and natur- (SFA), composed of legislator appointees al resources; federal budget; federal taxa- from each of the states, works through tion; fiscal affairs; health and human committees. The SFA, which also meets services; law and criminal justice; pen- three times a year, focuses on federal sions; trade and economic development; matters and their impact on state govern- transportation and communications; and ment operations. The SFA develops policy legislative management. positions on a wide range of state-federal issues for the approval of the entire Con- In each of these fields, staff members do ference. These policy resolutions, once research and can answer specific questions adopted, serve as the basis for the organiza- (for example, what are states doing about tion's lobbying efforts before Congress and special education? AIDS? child support? the administration. Those efforts regularly as liaison between the Conference and that include legislators' testimony before con- state's legislature. These "state assign- gressional committees and frequent meet- ment" people are listed in the January issue ings with members of Congress and the of State Legislatures magazine and in administration. LEGISNET. The Assembly on the Legislature and the State-Federal Assembly NCSL's Assembly on the Legislature (AOL), a joint undertaking of state law- makers and legislative staff members, is a SOUTH CAROLINA NEW JERSEY OKLAHOMA WYOMING FLORIDA GEORGIA THESE ARE SOME OF NCSL'S ACCOMPLISHMENTS FOR STATES IN 1988: Conducted workshops in Arkansas, Iowa, Recommended creation of a Puerto Rican Helped Arkansas, Louisiana, South Caro- Maine, New Hampshire, North Carolina Senate Budget Office and staff reorganiza- lina and Oregon reform their education and Pennsylvania on long-term care, tion and established evaluation procedures process, establish an agenda for education Medicaid, catastrophic care and alterna- at Puerto Rico's request. This project was and provide oversight of their reforms. tives to institutionalization. conducted with the Congressional Budget Office and the Congressional Research Revised and updated Mason's Manual of Helped develop a plan to assist Iowa in Service. Legislative Procedures, which will be pub- keeping abused children out of foster care lished and available to legislators in Jan- and with their families. This program uary, with the assistance of the legislatures' promises to become a national model. clerks and secretaries. Worked with the North Carolina Mental Developed a congressional lobbying strate- Health Study Commission to develop a gy with various public interest groups comprehensive plan for adult mental to change the Supreme Court ruling on health care and to create the Child Mental National Bellas Hess so states can collect Health and Youth Substance Abuse Plan. sales tax on mail order sales. Currently, some $2.4 billion in state sales tax goes Shared our expertise with the Arizona Joint uncollected nationally. Select Committee on State Revenues and Expenditures to develop sound criteria for Conducted 75 national meetings and semi- evaluating the state tax system in order to nars on topics ranging from asbestos clean- eliminate a structural deficit. up to child support enforcement to teen- age pregnancy to telecommunications. Evaluated legislative procedures at the Recommended revisions of the personnel request of the Alaska House and recom- policies of the Connecticut Legislature, as Published 22 books and reports on subjects mended improvements to streamline the well as a new staff structure and a fair and such as state tax reform, low birthweight process. equitable pay scale for employees, at the babies, art design legislation, mental health request of the Joint Committee on Legisla- and others. tive Management. Mailed over 3,000 documents requested by people who searched LEGISNET, NCSL's on-line information system. Defeated major pre-emption attempts by Congress in banking and corporate takeovers. MASSACHUSETTS PUERTO RICO ARKANSAS NEW YORK HAWAII UTAH OHIO NATIONAL CONFERENCE OF STATE LEGISLATURES Assembly on the Members All Legislators and Staff from the 50 States, State-Federal Assembly Legislature (AOL) Commonwealths and Territories (SFA) The Capitol-to-Capitol Governing Body 54-Member Executive Committee Comprised The State-Federal Connection Connection of Legislators and Staff AOL is a legislative forum for the exchange of ideas Staff Professional Researchers, Editors and Lobbyists in the The SFA consists of a and information among Denver and Washington, D.C. Offices steering committee and 11 standing committees that states. AOL committees and formulate policies task forces consist of legislators and legislative Services to States concerning states' interests Staff Sections before Congress and staffers, and oversee NCSL federal agencies. The SFA projects and publications NCSL staff provides NCSL provides training, also informs legislatures of and recommend state services to individual professional growth developments in state- action on the following legislators and staff, opportunities, and federal relations. topics: committees, and other information sharing for Committees include the legislative bodies. Services legislative staff. NCSL has a following: Arts, Tourism and include the following: Legislative Staff Cultural Resources Coordinating Committee Children, Families and Answering information Agriculture, Food Policy and nine staff sections that and Rural Development Social Services requests sponsor meetings, training Commerce, Labor and Criminal Justice Technical assistance in and publications. They are: Economic Development the states Regulation American Society of Education Fiscal Affairs and Publications (State Legislative Clerks and Oversight Legislatures magazine, Energy Secretaries Environment Legislative Organization Conference Report, books. National Association of Federal Budget and and Management research reports, Legislative Fiscal Officers Taxation Science, Technology and newsletters) Legal Services Staff Resource Planning Conferences, seminars, Government Operations Section and Pensions State Government Issues training sessions Legislative Program Health and Human and Organization Videotapes Evaluation Section Services Education Representing states' Legislative Research International Trade State-Local Relations interests before Congress Librarians Staff Section Law and Justice Reapportionment and federal agencies National Legislative Transportation and Service and Security Communications Association Leadership Staff Section Research and Committee Staff Section Computer Applications Staff Section NORTH CAROLINA VERMONT ALABAMA KENTUCKY WISCONSIN CALIFORNIA 1988-89 EXECUTIVE COMMITTEE Nunez Daniels Martin Strickland King O'Donnell Andreason Total membership of the Executive AT-LARGE LEGISLATOR MEMBERS Representative Alma Stallworth, Committee is 54 members: seven Speaker William Barrett, Nebraska Michigan officers, 21 at-large legislator members, Senator Robert Connor, Delaware Assembly Majority Leader James R. eight regional legislator members, four Senator Denton Darrington, Idaho Tallon Jr., New York ex-officio members, and 14 legislative House Speaker Pro Tem Lois M. Senator Diane Watson, California staff members. DeBerry, Tennessee Representative Wilhelmina Delco, Texas REGIONAL LEGISLATOR MEMBERS House Majority Caucus Chair Pauline Eastern Region Executive Director: William T. Pound Eisenstadt, New Mexico House Deputy Majority Leader Teresalee Senator Hugh Farley, New York Burtinuson, Connecticut OFFICERS House Minority Leader Art Hamilton, Representative James M. Burd, President: Senate President Pro Tem Arizona Pennsylvania Samuel Nunez Jr., Louisiana Senator Kelly Haney, Oklahoma President-Elect: House Minority Leader Representative Shirley Hankins, Midwest Region Lee Daniels, Illinois Washington Senator James B. Dunn, South Dakota Vice President: Speaker John Martin, Senate Majority Floor Leader Joseph Senator Bill Hutchins, Iowa Maine Harrison, Indiana Immediate Past President: Senate Representative Alex Harvin, South Southern Region President Ted Strickland, Colorado Carolina Representative Charles W. Capps Jr., Staff Chair: Betty King, Secretary of the Speaker Richard Kloubec, North Dakota Mississippi Senate, Texas Assemblywoman Gwen Moore, Senator Douglas Henry Jr., Tennessee Staff Vice Chair: Patrick J. O'Donnell, California Clerk of the Legislature, Nebraska House Majority Whip Robert O'Donnell, Western Region Immediate Past Staff Chair: John Pennsylvania Senate President Pro Tem Lawrence E. Andreason, Legislative Budget Director, Speaker Vern Riffe, Ohio Jacobsen, Nevada Idaho Representative Patricia Skinner, New Senator Anthony K.U. Chang, Hawaii Hampshire House Administration Leader Calvin Smyre, Georgia WEST VIRGINIA CONNECTICUT ILLINOIS NEBRASKA INDIANA TEXAS IOWA LEGISLATIVE STAFF MEMBERS Mr. John Turcotte, Executive Director, FOR MORE INFORMATION: Joint Committee on Performance Mr. Terry Anderson, Director, Evaluation and Expenditure Review, National Conference of State Legislatures Legislative Research Council, South Mississippi 1050 17th Street, Suite 2100 Dakota Mr. Jeffrey Wice, Special Counsel to the Denver, CO 80265 Mr. Mark D. Ausmus, General Counsel, Speaker, New York 303-623-7800 Office of the Speaker, Missouri Ms. Shelley Bates, Special Assistant to 444 North Capitol Street, N.W., Suite 500 the Speaker, California Washington, D.C. 20001 Ms. Lynda C. Davis, Director, Library 202-624-5400 and Information Services, Maryland Ms. Sally C. Diamond, Director, Legislative Council, Maine Ms. Sylvia Duke, Administrative Assistant to the President Pro Tem, Louisiana Mr. Ted Ferris, Director, Joint Legislative Budget Committee, Arizona Mr. James C. Heckman, Deputy Director, House Fiscal Agency, Michigan Mr. George Moser, Executive Director, House Legal and Fiscal Division, Oklahoma EX-OFFICIO Mr. Donald A. Rhodes, Director, Legislative Counsel Bureau, Nevada SFA Chair Mr. Donald J. Schneider, Chief Clerk of Speaker Gibson "Gib" Lewis, Texas the Senate, Wisconsin Mr. Wayne W. Todd Jr., Senate CSG Chair Sergeant-at-Arms, Florida Senate President Arnold Christensen, Utah AOL Chair House of Delegates Assistant Majority Floor Leader Nancy Kopp, Maryland AOL Staff Chair Mr. William Russell, Chief Counsel, Vermont ria-w a1324na--w r W bc-druguse:1150aes 1d 2-28 0658 (complete writethru - updating, adding reaction) By TAMARA HENRY WASHINGTON (UPI) - Use of crack cocaine has declined among high school seniors for the first time because of changing attitudes and Tuesday. increased knowledge about the drug's harmful effects, a survey said The 1988 National High School Senior Survey, conducted by The University of Michigan's Institute for Social Research, found use of all college. drugs generally declined among American students in high school and Overall, the proportion of seniors using any illicit drug during the prior year fell from 42 percent in 1987 to 39 percent in 1988. This compares with 54 percent in 1979, the peak year. But the study's director, Lloyd Johnston, said the drop. in the use of crack a highly addictive smokeable derivative of cocaine is ''one of the most important findings'' of the survey of some 16,000 to 17,000 seniors in 135 high schools nationwide. The survey also uses representative sample of college students and young adults one to 11 years beyond hi. n school. "This is great news, that our high school seniors are listening, that more are heeding the perils of drug use,'' said Education Secretary Lauro Cavazos. "However, too many of our youth, especially those that never become seniors the dropouts - still risk their health and their future by using drugs.'' The survey, the 14th in a series of national surveys funded by the National Institute on Drug Abuse, an arm of the Department of Health and Human Services, showed that 4.8 percent of all seniors between 1987 and 1988 reported ever using crack, compared with 5.6 percent in the previous year. Annual use of crack fell from 4 percent to 3.1 percent, after having leveled off between 1986 and 1987. Johnston, who warned in last year's report of an increase in crack use from 4 percent to 5.6 percent in 1987, said crack use showed a decline in 1988 among college students, as well, though not a statistically significant one - from 2 percent to 1.4 percent but there was little change among the 19- to 29-year-olds, from 3 - percent to 3. 1 percent. "We can safely 53y that this decrease suggests that nigh school seniors, a very important population to the Future of our country, are hearing the messages about cocaine's dangers and are avoiding drug use in general, said Charles Schuster, director of the National Institute on Drug Abuse. "While crack cocaine is readily available, seniors appear to be continue use. concerned about its addictive qualities and are less likely to try or Other key findings of the survey include: Marijuana use continued its long-term, gradual decline. About one-third of all high school seniors reported some marijuana use, compared with the peak year of 1979 when half of all seniors reported some use. Current daily marijuana use dropped from 10.7 percent in 1978 to 2.7 percent in 1988. Cocaine use dropped between 1986 and 1988 from 13 percent to B percent. Among college students, only 10 percent reported using the drug in 1988, compared with 17 percent in 1986. Cocaine use also fell among all high school graduates aged 19 to 28 from 20 percent annual prevalence in 1986 to 14 percent in 1988. Heroin use remained at 0.5 percent, the same percentage the past nine years. Alcohol use dropped for the first time in several years. Current drinkers'' - seniors who had one or more drinks in the past 30 days declined from 66 percent to 64 percent. - Cigarette smoking stands at 29 percent in 1988, with 18 percent of all seniors smoking daily. upi 02-28-89 11:51 aes - 11 - Blue Ribbon Schools continues the School Recognition Program, which in alternate years recognizes outstanding elementary and secondary schools. Schools are selected following an evaluation of their applications and on-site observations that focus on the school's philosophy, goals, organization, leadership, curriculum, instruction, student achievement, community relations, and efforts to maintain high quality programs and make improvements. The request includes an increase of $211,000 to cover the increase in costs of making on-site visits and other program activities. 4. Drug-Free Schools and Communities (BA in millions) 1990 1988 1989 Request State and Local Grants $191.5 $287.7 $297.5 Teacher Training --- 7.0 7.2 National Programs: Institutions of Higher Education. 17.8 27.8 28.7 Federal Activities 7.8 12.2 12.6 Programs for Indian Youth 2.2 3.5 3.6 Programs for Native Hawaiians 0.4 0.7 0.7 Regional Centers 10.0 15.6 16.2 Total 229.8 1/ 354.5 366.6 367 in 1/ Amounts for individual activities do not conform to statutory set-asides, because of the requirements of appropriations language. Bush BUDUCT The Department of Education is strongly committed to helping States and localities get drugs out of schools and off college campuses. The proposed funding increase for the Drug-Free Schools and Communities Act will provide follows: resources to help reach this goal. Under the Act, funds are allocated as State and local programs (82.8%) -- Funds are allocated to States and Territories on the basis of school-aged population. From each State grant, 30 percent is reserved for local programs administered from the Governor's office. The remaining 70 percent is administered by the State educational agency, which in turn must redistribute at least 90 percent of its share to local educational agencies. Provisions to ensure program accountability were strengthened by P.L. 100-297. Grants to Institutions of Higher Education (8%) -- Competitive awards are made to public and private institutions of higher education. At least 50 percent of the funds are used to develop and implement programs of drug abuse education and prevention for college students. The remainder of the funds are used for teacher training, summer institutes and workshops, and model demonstration programs designed to assist elementary and secondary schools. JIBS WITH Busit PLANK - 12 - Federal Activities (3.5%) -- Funds are available for communicating the the developing and disseminating audio-visual and other curricular materials at dangers of drug and alcohol use to students at all educational levels; identifying research and development priorities; and providing information elementary and secondary levels; providing technical assistance; on drug abuse education and prevention to the Department of Health and Human Services for its clearinghouse under the Public Health Service The Department has used Federal Activities funds to support a Network Act. of Drug-Free Colleges and Universities, establish a program to recognize schools with exemplary programs to combat drug abuse, support the that follows the principles outlined in Schools Without Drugs, and fund "Challenge" campaign, which enlists schools in a fight against drug abuse education programs. The Department completed, with the Department of discretionary grants for the development of comprehensive drug and alcohol Health and Human Services, a congressionally mandated study of the Schools and is now carrying out a study of the implementation of the Drug-Free effectiveness of existing programs of drug abuse education and prevention national distribution of anti-drug abuse videocassettes appropriate for and Communities Act. The Department also funded the production and children at various age levels. Programs for Indian Youth (1%) -- Funds under this program are transferred to the Bureau of Indian Affairs and used to plan, conduct, and administer by or under contract with the Bureau. programs for Indian children in elementary and secondary schools operated Programs for Hawaiian Natives (.2%) -- Funds have been awarded by Governor of Hawaii, to plan, conduct, and administer programs for Kamehameha the Schools/Bernice Pauahi Bishop Estate, an organization to designated the Hawaiian Natives. Regional Centers (4.5%) -- Five regional centers have been established to train school teams in effective approaches to drug and alcohol abuse prevention; assist State educational agencies in coordinating and of strengthening programs; assist local educational agencies and institutions higher education in developing training programs for educational and personnel; and evaluate and disseminate information on effective programs strategies. Teacher Training programs, which were recently authorized under Anti-Drug are used Abuse Act of 1988, receive a separate appropriation. These the funds to establish, expand, or enhance programs to educate abuse administrators, counselors, and other educational personnel about teachers, drug education and prevention. 1989. Drug-Free Schools programs received a 54 percent appropriations increase in The Department proposes an additional 3.4 percent increase in 1990. 2/27/89 Dick Weatherby 3pm GRAnts Plus pop. % $500,000 to every state 80% non-DISCRETIONALY 20% DISCRETIONARY (1) CRACK TASK FORCE (2) "DEMONSTRATION project"- STATEWIDE DRUG PROS. units, (3) STATEWIDE DIVERSION CbAd DOCTORS, bas pharm.) (4) DRUG ABUSE ED. PROGRAMS (5) STATEWIDE PROS, Units (6) PRISONS? * proceeds of state & local agencis that also, fed. law agencies can share Cooperate assets in SEIZURE + FORFEITURE OF unders of millions of Dodnes Male the duy dealers puy for law enformed PRESIDENT BUSH MARCH 3, 1989 PAGE 5 And yet, well before the end of the century, the oceans of the world had seen the last slaving ship set sail. World intolerance grew until slaving ships could no longer find an open port. world. ThE indibnation OF A Eew committed people mood the Today, the oceans and airways of the world are transporting a different kind of trade that results in a more subtle form of five slavery My friends, we will not defeat the drug lords tomorrow. We will not defeat them next year or in the year after that. a But with the brave cooperation of our neighboring nations, we will fight, and we will not stop at any point short of victory SCAVE-HOLDERS of TODAY. DRUGS ARE THE This is the message I want Dick Thornburgh to convey to the Justice Ministers of Latin America. I am confident that Dick will do a splendid job. And I want him to know that he leaves with the heartfelt thanks of us all. # # # STATES Mrs MUST TOUGHEW CAW LOOK AT DRUG FACT. - HEET TAKE AWAY - How many STATES REVOKE LICENSES - CA BUSH CALLS on ALL STATES $ 4,1B. DRUO - DRIEWTED P. FACT Any BUDGET FED, DEATH PEWALTY INCLUDES STATE + LOCAL STATES All Four = - BREAK DOWN $4. I BiLLiON - PRiSON $ FOR FED. PRISONS. - EDUCATION $ TO STATE DEPTS of ED. BENNETT people WASHINGTON 2/28/89 Natt Groc. of Conening 624-5300 Milan JONES (JUSTICE) 624-5360 Martinez SURVEY fact sheet TASK FORCE - Cono. / Sewaina Davis/Dooley March 2, 1989 3 p.m. REMARKS: NATIONAL CONFERENCE OF STATE LEGISLATORS OLD EXECUTIVE OFFICE BUILDING/RM 450 MARCH 10, 1989 ? Thank you Sammy Nunez (Noo-nez). Thank you Lee Daniels. Thank you all. The last time I spoke to you, we were in the middle of America, in the middle of summer, and in the midst of a tough campaign year. Fate has smiled on us since that July day in Indianapolis. Then, we were all candidates. Today, everyone in this room is a winner. For those of you who are Republicans, I hope my coattails were of use. For those of you who are Democrats, I claim absolutely no credit whatsoever In all sincerity, I want to congratulate every legislative leader in this room, Democratic as well as Republican. You won more than a political victory. You won the highest honor of all -- the opportunity to serve your state and your country. 2 The problems that confront our country as we near the end of this century often seem bigger than our ability to solve them. And they are -- if we face these problems as only partisan Democrats or Republicans, as parochial members of a region, or a faction, or an interest group. But by working together, as Americans, we can lick any problem -- no matter how big, how complex or how deeply rooted it may be. True, there are always naysayers who say that we will never clean up the environment; that we will never shelter the homeless; never solve the age-old affliction of mankind -- poverty -- poverty of knowledge and skills, poverty of opportunity, poverty of hope. But the cynics never take into account one of the great success stories of our times -- state government. In this decade, power flowed from Washington to Austin, to Springfield, to Sacramento and to every other state capital. With this power came new responsibilities. And history will remember that you met your broadened responsibilities with distinction. I know funds at all levels of government are tight. I know you are called upon to make hard choices, as I am. But, by and large, you are meeting the challenge of a frugal age by devising creative new solutions to the age-old problems of care and concern for the very young, the very elderly, the disadvantaged and the dispossessed. 3 So whenever I see a problem that some say is insurmountable, I draw inspiration from what you are already doing in the states. The resilience of state government in the 1980s vindicates the wisdom of the Founding Fathers, and forever discredits those who would have Washington do it all. Let me assure you: I will preserve and protect a healthy balance, a sharing of power, between the states and Washington. As you know, one policy area clearly designated as a prime responsibility of the federal government is our national defense. So perhaps the appeal I am going to make to you today will be all the more unprecedented. The time has come for me to enlist your energy and expertise in a different kind of national security crisis -- the threat of drug abuse to the health and the very future of our nation. Crack. Heroin. P.C.P. These drugs are a plague that leave shattered minds, ruined bodies and wasted potential in their wake. No state in the Union is immune to this plague. Drug crimes have claimed thousands of lives, and turned whole communities upside down from the Eastern Seaboard to the Pacific Coast. It is becoming apparent that our struggle against the drug trade is more than the moral equivalent of war. It is war. 4 As with every battle this country has ever fought, we are all in this together -- as Americans. And as with any war, we must have a strategy. Our strategy is four-pronged: law enforcement -- interdiction -- rehabilitation -- and prevention through education. I am pleased to see so how many state governments have formed intrastate drug task forces, and interstate panels to share resources and intelligence. Every state should be encouraged to join this common effort. The federal government, just like the states, is motivated by a new get-tough attitude on drugs. We've stiffened the federal sentence for drug trafficking to a maximum of life. We've toughened penalties for drug dealers who use children to deal drugs, or who sell drugs to children. And if you commit a drug-related murder, or slay a law enforcement officer, the toughest sentence you can receive is the toughest sentence there is -- death. We've also increased our resources as we've stiffened sentences. Since 1981, the federal anti-drug budget has grown by nearly 370 percent. But more was needed, so I am asking the Congress for $6 billion for our anti-drug program in 1990 -- a 21 percent increase over 1989, and a 47 percent increase over 1988. More than $4 billion will be spent to provide grants to state and local law enforcement agencies, to beef up federal enforcement, and to enhance our prosecution, detention and intelligence capabilities + Ampted in Jan tobe eltiminated which was sebudula As. com. 5 SUSTAINM the This includes an allocation of $150 million for the Department of Justice drug grant program to help state and local Moore law enforcement agencies in catching criminals and warning kids away from drugs. Your Another shining example of federal and state cooperation is the seizure and forfeiture of assets from drug dealers. State agencies that cooperate in drug cases will share the benefits NOT new from the sale of yachts, planes and autos used in drug deals. To convert the profits of vice to finance our war against the multi-billion dollar drug empire is more than good financial sense. It is sweet irony and swift justice And speaking of justice, I call upon you to scrutinize state anti-drug laws, looking for ways to tighten them. should In this war against drugs, we can draw inspiration from the words that inspired a nation at war almost fifty years ago, words that are just as fitting today. If I may paraphrase Winston Churchill, we must fight the drug lords on the beaches and the streets, we shall fight in the schools, we shall interdict them in the skies and on the high seas. We shall never surrender, not until the last playground is free of drugs, the last pusher behind bars. 6 Pehaps the classroom will be the most decisive battleground. 16% Toward this end, I am proposing a $1.1 billion allocation for drug education. Some $367 million of this will go to the $ 12m. Department of Education budget, to help keep drugs out of our schools, campuses and neighborhoods. Our mission is as difficult as it is simple: to keep kids off of drugs and out of trouble. You will be able to take the lead in this effort, since more than 80 percent of the funds of this program will be allocated to the 16% states and territories. As you may have heard, we can already take heart from some good news from the classrooms of America. According to the 1988 National High School Senior Survey, the proportion of seniors using illicit drugs during the prior year fell from 42 percent in 1987 to 39 percent in 1988. This compares with the peak year of 1979, when an astounding 54 percent of all American high school seniors abused drugs. Still, 39 percent is 39 percent more than I will accept. How can we convince these teen-agers to leave drugs alone? Let me tell you, Presidents usually do not speak in favor of intolerance. But the day must soon come when this nation is utterly intolerant of so-called casual drug abuse. Then, and only then, will we be able to declare victory. 7 It is with this in mind that I hope the Senate soon confirms Bill Bennett as the nation's drug czar. Bill's talent as an educator, and his rapport with young people, will be of particular help in communicating our attitude of zero tolerance to the next generation. Over the next four years, we will face many common challenges -- to our environment, to our prosperity, to our compassion for those who have yet to fully participate in the American Dream. But we face no common domestic challenge as grave or as urgent as that of drug abuse. I pledge to work with you and your state governments in this struggle. Just as war tested the courage and character of the British people, so our people today are undergoing a test of national will. We shall neither flag nor fail. We shall go on to the end fighting the scourge of drug abuse. we shall never surrender. With your help, and your leadership at the state level, I know that we will prevail. Thank you. # # # THE WHITE HOUSE Office of the Press Secretary For Immediate Release March 14, 1989 REMARKS BY THE PRESIDENT TO THE INDEPENDENT INSURANCE AGENTS OF AMERICA ANNUAL NATIONAL LEGISLATIVE CONFERENCE Capital Hilton Hotel Washington, D.C. 10:18 A.M. EST THE PRESIDENT: Thank you all very, very much. Larry understands -- (laughter) -- but if I look a little frantic, our dog is expecting. (Laughter.) And if you think I look frantic, you ought to see the Silver Fox. (Laughter.) That's Barbara. (Applause.) No, but I'm delighted to be here; appreciate that warm welcome, complete with a few scattered Texas flags in the audience. And it is an honor to be before this group. In this city, the currency of status is measured in titles, honorifics -- senator, ambassador, secretary. But in my book, this group holds one of the most impressive titles of all -- entrepreneur. And I know that the hunger that you feel to own a firm of your own, start from scratch, build it, watch it grow. And I know the satisfaction of matching resources to needs and meeting deadlines and meeting payrolls. A few years after World War II, when I got out of college, I moved out to west Texas, and a couple of years after that, the early '50s, started my own business. And it was a very small firm -- not too small to teach me the facts of economic life. But we got started by risk-taking; got the business education by helping others make that company grow. And our company was a high-risk venture. There was new technology that was unproven, full of half-starts and failures in that -- it was all called the off-shore drilling business. And we took a gamble and we invested in new technology. And then we eventually succeeded in pioneering a new way to find America's energy. And it wasn't always easy, even in the years that the company did reasonably well. And I recall our despair one time -- and some of you in your business know what I'm talking about when you think of insurance - when one of those hurricanes swept through the Gulf of Mexico and one-third of our company's assets were invested in a brand new drilling rig, with brand new technology -- a hurricane swept through the Gulf and I went out with our drilling engineer and rented a little Piper -- maybe it was a twin engine plane but anyway, in the aftermath of the hurricane, and looked and looked and looked. And the rig had totally vanished. People had been taken off before the storm, but the rig was gone. One-third of the investment of our company totally disappeared. But from that and other such similar events, I learned some very important lessons. When that rig went down and people lost their jobs, when we rebuilt, there was the satisfaction of seeing people go back to work. And I saw the strain on the faces of the family breadwinners, but I also saw the joy. So Washington may not always appreciate the role of small business in creating jobs. But I do and I think you know, I used to get needled about the resume to bring to be President of the United States. But like you, I think one of the most important MORE - 2 - things is the private sector taking risks, competing, starting small businesses. And I hope I never forget the lessons that I learned as a small businessman. I also appreciate this industry's role in society. Without insurance, the loss of spouse could mean the loss of a home. Without insurance the loss of a parent could keep a child from attending college. We cannot offer protection against fate, but we can prevent the compounding of a tragedy so that a death or an illness doesn't leave a bitter legacy of poverty or dispair for a whole family. You prevent that kind of double tragedy, and you add a little bit of comfort to the grieving and predictability for those who are victims of the unpredictable. So this is your service to society. It's as crucial a service as that of any social welfare agency. And you cannot continue to perform it if your industry is hamstrung by excessive regulation. (Applause.) And that's why we have worked to remove excessive regulations the job's not done to free the creative energies of small firms by ordering a review of more than 100 government regulations. The task force on regulatory relief, which I chaired as Vice President, saved the private sector more than 600 million man-hours of paperwork and billions of dollars in government compliance costs. And I want to work now to continue to work to free small business of the remaining excesses of regulation. (Applause.) My philosophy is this; that when it comes to necessary regulation of business, I'm committed to letting the states take the lead, not the federal government. (Applause.) Reducing the regulatory burden is important. But we've got to take action on other fronts as well, if we're able to keep if we're going to do our part in keeping American small business strong. And that's why I've also proposed a cut in the capital gains tax rate. Most of our major trading partners do not tax long-term capital gains. They understand that a high capital gains tax unnecessarily hurts our competitive position by drying up the formation of capital, business, and jobs. In 1978, when the Congress cut the maximum tax rate on capital gains, the result was an explosion of new companies and new revenues. The critics were still out there, back in '78, saying if you do this, you're going to lose revenues; if you do this, it's an advantage for the rich. Didn't work out that way. The Treasury estimates that the new cut that I am proposing will add $4.8 billion to the revenue side in Fiscal Year 1990 alone. So let the critics carp. I am going to push for this idea that will stimulate jobs, risk-taking, capital formation. And it's good for the economy and it is not a special tax break for the rich. (Applause.) Small businesses with less than 500 employees employ more than half of the U.S. workers. You understand this, but I don't believe many people in the United States understand it. So any onerous new burden on small business will also throw workers out of their jobs. And it's for that reason that I oppose this kind of mounting movement towards mandated employee benefits. (Applause.) In an area of tight budgets, there's always the temptation to drop the burden of social programs on the backs of the employers. But these policies, borne, I would say, of the best of intentions, can have unintended and counterproductive consequences. It's up to business and labor to negotiate their differences. And make no mistake I support the right of labor to negotiate as an equal. But burdensome mandated benefits serve neither business, nor labor. We've seen what happens in other countries, where mandated benefit programs create obstacles to productivitiy and growth and, thus, to new job creation. We cannot build a better America if we weigh down our own productive sector with mandated new MORE - 3 - burdens. And let me address one other area that concerns business and that, perhaps, you in this room are much more sensitive your to than others. And I'm talking about tort reform. Of course, there are many litigants who deserve a jury's sympathy -- we can start from when businesses are bankrupted, when mothers struggle to find an that premise. But when local governments cannot install playgrounds, obstetrician, when volunteer organizations -- boyscouts and girlscouts and others -- have to pull back for fear of excessive claims leveled against them, then it is time to consider limiting some of these outrageous settlements. (Applause.) Tort reform is critical to the health of businesses and volunteer organizations alike. All of our policies are directed toward a single goal -- building a better America. And to achieve priorities, an attack on the deficit, hold the line on taxes -- no this goal, my plan has four broad objectives: attention to urgent private fail. sector, our nation would be mired in the past, doomed to new taxes -- and an investment in the future. And without a strong ready for change but who relishes the thought of it. And this The entrepreneur is the man or the woman who is not only thought leads me to speak to you in more general terms now about presidency, the challenges I hope to meet, the accomplishments that my I hope we can make for our country. I'm a man of this century. I fought in the century's mid-century of America's greatness. But I want to be a President who greatest war and raised a family and built a business during the is remembered for preparing our country for the next century. This is my entrepreneurial definition of leadership -- to see the shape of things to come and to prepare for that 21st century world only 11 swift and fast as a torrent. Change in the American family, in our years away. By the year 2000, we will have experienced change as work habits, change in technology and change in the world economy. Change in the rate of change itself. constantly. But the qualities on which it was founded are timeless The makeup of our remarkable nation has been evolving and true. And one of those constants is that we are an entrepreneurial people, at our best when we are challenged and when ve boldly face the future. problems of the future today. A complacent society is doomed to And so my agenda is this: to confront the emerging comfortable decline. And we are not complacent. A dynamic society is one that keeps pace with the times. So call it that if you will -- a dynamic America. But recognize in the restless drive and vision of the American entrepreneur our best qualities as a nation. A complacent nation would take comfort that America is free in a world at peace. But world events are moving too swiftly for us to relax in set ways and to cling to smug assumptions. The question we must answer is will American foreign policy be flexible developments? enough to meet the emerging and potentially dramatic new world And with this question in mind, I've asked all the appropriate agencies --state Department, Defense, other agencies -- to reassess our foreign policy and defense strategy. And this comprehensive review will set the basis for our future actions and guide America into the next decade and toward the next century. I see a couple of kids here. I believe they have a chance to grow up in a more peaceful world. I believe we have, with the changes in the Soviet Union, great challenge, but also great opportunity. But the answer is not to rush in. The answer is to take a prudent re-evaluation and then move forward with the rest of the free world. ieadership that only the United States of America can provide the MORE - 4 - On economic policy, I've submitted to the Congress a budget that is fiscally responsible. This budget does four things: It substantially reduces the deficit, it includes no new taxes, it -- (applause) -- it addresses key priorities, and it still provides for important investments which will help make us more competitive in the future. My speech to Congress, incidentally, was accompanied by 193 pages of specific recommendations for the budget. And looking back in the history books, if you will permit a comment about -- it might side a little bit prideful -- we found that no other president in recent history has presented quite so much information to Congress at such an early date. And I've also submitted a proposal to solve a festering problem that threatens our future prosperity -- a plan to restore the integrity of our nation's savings and loan institutions. It's an enormous problem, and our plan has been well-received on both sides of the aisle on Capitol Hill. I've asked the Congress to take action within 45 days; challenged them, now that we've come up with the proposal, to move forward. This problem requires prompt and prudent action. The changing nature of American society to more working parents is putting pressure on our most basic social institution. I'm talking about the family. How will we respond to this change? We simply cannot afford to create some massive new entitlement program. And that's why I am proposing a child care plan that combines tax credits and private sector resources to offer parents a choice. I want to empower parents, not government, to seek the best and safest environment for their children. And the underpinning of my plan is the family -- (applause) -- strength in the American family. But many other areas of change. Homelessness affects a small proportion of Americans, but concerns us all. I drove here today or when you look out the window of the White House and see the ragged, pathetic figures huddled over the steam grates of the Ellipse, I see an affront to the American dream -- a national shame, if you will. And we must seek the root causes of and devise the most practical solutions for the homelessness. The environment, once the concern of a far-sighted few, is now a top priority of my administration at home and abroad. You know, this isn't a conservative or a liberal question -- the question of the environment. I think of Teddy Roosevelt as one of the great conservationists, one of the great environmentalists. The time has come to lay aside partisan approach to these enormous enviromental questions. We must devise a global approach to the problem of ozone depletion and global warming. We intend to make rapid progress on acid rain and see that a new clean air bill is produced. And we've already broken ground in joining with other nations to call for the elimination of the CFCs in adopting a tough new policy on the export of hazardous waste. And there's drugs. The scourge of drug abuse will test our resolve and a mettle as a people. I'll bet you if I could talk to each one of you in a family setting, that you'd tell me the things that concern you the most is the question of drugs -- how it's affecting your schools; how it's affecting your own children or your grandchildren. And I'm concerned, as well. And I'm asking the Congress for $6 billion for our antidrug program in 1990 to beef up drug education, rehabilitation, law enforcement and, yes, interdiction. And I'm also pleased that we have a strong, new drug czar. I'm a little confused as to why, in the United States -- (laughter) -- we want a strong, new leader, we call him a czar. (Laughter.) But nevertheless, that's -- I'll defer to the Congress on this one. (Laughter and applause.) We've got a strong one. Call him a leader, call him a czar -- Bill Bennett. And he's at my side, shoulder-to-shoulder to guide and coordinate this all-out effort MORE - 5 - against drugs. And it's not easy. When you look at the complexity of the federal government and the number of the agencies that are involved in this question of antinarcotics, it is a massive executive coordinative job. And Bill Bennett will be superb as the first drug czar. And finally, I want to single out one area which in so many ways is preeminently important to our nation. I am sure it is of particular importance to your family. We have got to protect and strengthen our schools. You and I know that education is our most enduring legacy. And you and I know that education is nothing less than the very heart and soul of our civilization. I want that control to remain with the families and the PTA and the local school boards and the states before the federal government when it comes to the control of our educational process, of our curriculum. And I will resist any effort to centralize all the answers for education here in Washington, D.C. But, you know, education is this enduring legacy. And as we face a new decade and a new century, we also face a new challenge to revitalize and restore the system that our forebears bequeathed to us to ensure that American education is second to none. And I've made a number of proposals to work towards this goal, work with the states and the local to achieve that goal. Among them is my request to reward those schools whose students show measurable progress is educational achievement while maintaining a safe and drug-free environment. I've also asked for an annual fund of $100 million in new appropriations to help create magnet schools to broaden the educational choice of parents and students. And I've made many other proposals, including programs to strengthen the historically black colleges and universities, to reward our best teachers. And I appeal to you to get active in your schools, to share your knowledge, expertise and resources where it is most needed. I've laid out in broad terms, then, this agenda for building a better America. And, yes, it is ambitious, but it is no less ambitious, no less dynamic than the American people themselves. And as the businessmen and women, you can help me to fulfull this agenda, to meet the challenges that face our country. By working together, we can achieve absolutely anything. And so the problems seem big at times out there, but believe me, never underestimate the ability of the American people if we together set out sights on achieving certain goals. I need your help. I'm delighted to be here, and thank you for inviting me. (Applause.) END 10:41 A.M. EST DAVIS I DOOLIEY THE WHITE HOUSE Office of the Press Secretary For Immediate Release March 10, 1989 REMARKS BY THE PRESIDENT TO NATIONAL CONFERENCE OF STATE LEGISLATORS Room 450 Old Executive Office Building 11:11 A.M. EST THE PRESIDENT: Thank you very, very much. It's good to see all of you. Listen, nice welcome, thank you. To our Secretary -- Secretary Dole, my greetings. Delighted to see you here. And Andy Card, and our -- ripped off right out of the ranks of one of your states, the former speaker, Deb Anderson here, who I'm delighted to see in her official duties. And I'm pleased to be here. And I would like to thank the president and past officers for your gracious invitiation -- Sammy Nunez, Lee Daniels, Ted Strickland. I thank all of you. The last time I spoke, we were in the middle of America, in the middle of summer, and in the midst of a tough campaign year. Fate has smiled since that July day in Indianapolis. Then, we were all candidates. Probably everybody in this room -- maybe an overstatement. Today everyone in this room is a winner. And for those of you who are Republicans, you discerning devils, -- (laughter) -- there was a time -- I've got to admit, there was a time when I thought I'd drag all of you down. But here we are. (Laughter.) And for those of you who are Democrats, I'd like to claim credit, but I can't figure out how at all. But anyway, well done. And in all sincerity, I do want to congratulate every legislative leader in this room, Democrat and Republican alike, because you did win more than a political victory. The highest honor of all you won -- opportunity to serve. And I really still -- I feel that way, have always felt that way about public service. And certainly you do, or you wouldn't be here today. The problems that confront our country as we near the end of this century often seem bigger than our individual ability to solve them. And they are big. And if we face these problems as only, partisans -- Democrats or Republicans -- or parochial members of a region, or a faction, or an interest group, we've got real problems. But by working together, as Americans, we can, I believe, lick any problem -- no matter how big, how complex or how deeply rooted it may be. There are always naysayers who believe we're going to never clean up the environment or never shelter the homeless, never end that old-age affliction of mankind, poverty -- poverty of knowledge and skills, of opportunity, and the poverty of hope. But the cynics never take into account one of the great success stories of our times. And I am talking about state government. In this decade, power flowed from Washington to Austin, to Atlanta, to Sacramento and to every other state capital. And with it came new responsibilities. I'm talking, of course, of the concept of federalism. And history will remember that you met these broadened responsibilities with distinction. I know that funds at all levels of state government are MORE - 2 - tight. All levels of federal government are tight. And I know that you're called on every day to make the hard choices, as I am. But, by and large, you are meeting the challenge of a frugal age by devising creative new solutions to these age-old problems of care and concern for the very young, the very elderly, the disadvantaged, the dispossessed. So whenever I see a problem that some say is insurmountable, I draw inspiration from what you are already doing in the states. The resilience of the state government -- state governments in the '80s vindicates, in my view, the wisdom of the Founding Fathers, and forever discredits those who would have Washington do it all. And let me assure you, I will preserve and protect a healthy balance, a sharing of power, between the states and Washington because I fervently believe that federalism works. And I remember meetings that I had with governors at the time of the campaign discussing the social issues. And I learned more from the briefings -- this happened to be in a partisan context of a campaign but I learned more from the briefing by the governors than any of the people here in Washington to whom I had access because I was Vice President. And I thought about why it made such a difference and why I learned so much from them, and it was because they're on the cutting edge; they are out there working with you all to solve the problems, to figure out what works, to make the changes. And so that may sound elementary to some, but I think you must know what I mean governors have to deal in what works. And they get that from you all with the representation you have give in your districts. As you know, one policy area clearly designated to us here is national defense. And so perhaps the appeal I'm going to make to you today will be all the more unprecedented. The time has come for me to enlist your energy and expertise in another national security crisis. And you know what it is and I know what it is and the American people know what it is -- and I'm talking, of course, about the threat of drug abuse to the health and the very future of our nation. I wish that each and every one of you could have been with me yesterday in New York when I went to the DEA headquarters and I talked with the widow of the fallen the latest victim of the drug criminals at my side talked to the agents there. But the best part was the meeting afterward, talking in a very private setting to those agents who are undercover, couldn't be out there in public, but who told me, case by case, of the problems they face. And I don't want to get away from the text here too far, but the thing that really impressed me -- and I expect some of you who have had leadership roles in your states could talk to this is that the culture has changed. They say it used to be if you came in and identified yourself as a Fed or a police officer of any sort and drew a weapon on these people, they'd give up. And now they automatically shoot. They go to the barricades. And there's some reasons for that. They get the same penalty for killing a police officer as they get for being caught with a certain amount of narcotics. We've got to do something about that. Crack, heroin, PCP -- these drugs are a plague that leave an aftermath of shattered minds and, you know, totally wasted potential. No state in the Union is immune to this plague. And drug crimes have claimed thousands of lives, and having seen some of the barricaded crack houses that have been knocked down by the battering rams of the police, it's everywhere. Los Angeles I went out there one evening and took a look with Daryl Gates at what his officers face every day, and I'll tell you, it really drives it home. MORE - 3 - As with every battle this country's ever fought, we are in it together as Americans. And as with a war, we've got to have a strategy, and ours is education, rehabilitation, law enforcement, and then doing better in interdiction. I'm encouraged to see so many state governments forming these intrastate drug task forces and interstate panels to share resources and intelligence. And I would appeal to every state to join these efforts. Every state should look for ways to toughen its drug laws. The federal government, just like the states, is animated by a new get-tough attitude on drugs. And we've stiffened the federal sentence for drug trafficking to a maximum of life. We've toughened penalties for dealers who use children to deal drugs or selll drugs to the kids. And if you commit a drug-related murder or kill a cop, the toughest sentence you can receive is now the toughest sentence there is, and that is the death penalty. And we've also increased our resources as we've stiffened the sentences. Since 1981, the federal antidrug budget has grown by nearly 370 percent. But more was needed, so I'm asking the Congress for $6 billion for our antidrug program in 1990 -- more than $4 billion will be spent to provide grants to the state and local law enforcement agencies to beef up the federal enforcement, to enhance our prosecution, detention, and intelligence capabilities. And this includes sustaining the 150 million drug grant programs so that the Department of Justice can help state and local law enforcement agencies catch criminals and warn kids away from drugs. Another shining example of federal and state cooperation -- the seizure and forfeiture of assets from drug dealers. State agencies that cooperate in drug cases will share the benefits from the sale of yachts, planes, and cars in used drug deals. Again, my experience yesterday the head of the DEA showed me a table -- $20 million of cash that they had taken in one -- that they had gotten in one -- a part of it. I don't think all $20 million was on that table, but a lot of it was -- in small bills, incidentally -- 20s, 10s, that kind of thing. They had taken this money in one -- caught one truck loaded with $20 million and nobody claimed it. Nobody even inquired about it. Obviously, they didn't want to get in too much trouble. (Laughter.) But there was no undercover inquiry. That's just the cost of doing business. So $20 million is down the tube and go on about our business. Same as they dump their airplanes in the water off the Bahamas the cost of business. Three Cesnas and that's the cost of getting the stuff in here. But even with these programs, the campaign against drug abuse will be hard-fought. It's a war and it's going to last for years. And perhaps we should take inspiration from a nation at war almost 50 years ago. As Britain faced an adversary that tested the courage and character of its people, Winston Churchill vowed never to surrender. And in today's war against the pushers, we must draw from these same deep wells of national purpose to summon the spirit of defiance. Our single most important task is to keep the kids off of drugs and out of trouble, and toward this end I am proposing a $1.1 billion allocation for drug education and prevention -- a 16 percent increase over 1989. Some $367 million of this is going to go to the drug-free schools and communities program to help keep the drugs out of our schools, campuses and neighborhoods -- an increase of $12 million here. The programs are many. You're going to be able to take the lead in this effort since more than 80 percent of the funds of the drug-free schools and communities will be allocated to the states and territories. As you may have heard, we can already take heart from some good news from the classrooms. According to the 1988 National High School Senior Survey, the proportion of seniors using illicit MORE - 4 - drugs during the prior year fell from 42 percent in '87 to 39 percent -- a modest drop, but at least a decrease. This compares with the peak year of '79, incidently, when an astounding 54 percent of all American high school seniors used drugs. Still, 39 percent is horrible. And we're going to spend money to get the job done, but we need to change something. We've got to have a national attitude of intolerance. Let me tell you, presidents don't normally speak out in favor of intolerance, but the day must soon come when the nation is utterly intolerant of this casual drug abuse. Back to yesterday -- one of the undercover agents telling me about the white collar use. This guy was down somewhere on Wall Street and it was just considered normal in the firm in which he was operating to -- at the end of the day, to offer to the people doing the clerical work there some kind of line of cocaine if they would stay for an extra few hours. I mean we've got to change that whole toleration, that whole cultural identity that suggests that this is the fast lane, or the easy way, or that it's okay. Over the next four years we're going to face a lot of common challenges. The environment -- I do want to do something on that. With the help of the states I'm convinced we can here. To our prosperity -- we're going to ask your forebearance as we call for some tough measures to face down this federal budget deficit. To our compassion -- for those who have yet to participate fully in the American dream. And the challenge of drug abuse is going to test our resolve and our mettle as a people. So I just wanted to tell you and pledge to you, leader to leader, that I want to work with you in the state governments in this struggle. Bill Bennett, our new drug czar, is charged with coming up with a national strategy, a national direction in six months after he takes office. He'll be good, he'll be tough. He's got a difficult assignment because of the way government works. Picture in your own state governments -- it's a little it's not a very neat and easy way to draw the organization chart because he has to not only get the attention of the Defense Department or the Attorney Generals without the standing, protocol standing over them, he's got to get their attention and have us all marching in the same direction. So what that means is the President is going to have to be shoulder-to-shoulder with Bill Bennett. And I'm prepared to spend the time and devote the energy necessary to give it that stature because it won't happen if it just bogs down in some kind of bureaucratic turf fights over who's going to do what on interdiction, or education, or crime-fighting, or whatever it is. So I wanted to tell you we do want to work with the states. War tested America and her allies in the '40s, and so our people are undergoing a test of national will today. To paraphrase Churchill again, we shall not flag or fail. We're going to go on to end the fighting of this -- to keep going to win the fight against the scurge of drugs. And I'm confident; I believe it can be done because I sense a change in the country. I sense people -- it's more than rhetoric now. I think it's into every community, every state, and certainly all through the federal government. So we're not going to give up on this one. We need your help, we need your leadership, we need your ideals. I wish that we had more funds to put in a program here or support of an initiative there. But I don't want to mislead you. We're dealing in a time of very constrained federal resources. So we've got to do a lot, working with you and working with programs that I refer to as the thousand points of light -- the willingness of one citizen out there willing to help another. And so thank you for what you're doing, thank you for coming here to the White House. I'm delighted to see each and every one of you. God bless you all. Thank you. (Applause.) END 11:28 A.M. EST Nolan E. Jones Committee Director Justice and Public Safety National Governors' Association HALL OF THE STATES 444 North Capitol Street Washington, D.C. 20001 (202) 624-5360 GVERN July 8, 1988 RS' Volume 22 Number 28 Published by the National BULLETIN Governors' Association States Step Up Illinois is creating a multijurisdictional prosecu- tion program, upgrading crime laboratories, creat- ing a statewide computer network with informa- Attacks on Drugs tion on drug offenders, establishing an equipment arsenal for local enforcement agencies, and set- Through systemwide efforts, states ting up treatment programs for drug-dependent offenders. are addressing the problem The Michigan Model for Comprehensive School aggressively and comprehensively Health Education, initiated by Gov. James J. Blan- chard in 1984, has taught more than 500,000 chil- dren of the dangers of alcohol and drug abuse. By Mark Miller Treating substance abuse a part of a larger pattern stablishing anti-drug campaigns as a fun- that includes school failure, teenage pregnancy, E damental state government activity- and delinquency, the program focuses on devel- such as promoting economic growth or ops strong self-concepts to help children resist encouraging excellence in education- peer pressure. states are attacking drug abuse and drug traffick- NGA's policy on drug abuse and drug trafficking ing with comprehensive efforts involving preven- states that "to be successful, a drug prevention tion, enforcement, and treatment. For example: campaign must be planned as an ongoing and South Carolina Gov. Carroll A. Campbell Jr. re- long-term commitment, and to be sustained it cently announced the creation of the RAID Team must be community-based. Governors can play a (Retaliation Against Illegal Drugs), a strike force of key role in mobilizing local coalitions that are just law enforcement officials that will crack down on as broad-based as the statewide alliance." establishments where illegal drugs are bought In line with this policy, the governors have taken and sold; coordinate marijuana eradication ef- the lead in coordinating drug abuse policy and forts; and assist understaffed local law enforce- pooling state resources for comprehensive and ment agencies. Continued on page 2 Governors, Lyng, Congressional Leaders Agree To Move Ahead Quickly on Drought Assistance Bill for Farmers, Ranchers G overnors from guage of current pro- budget limits. NGA will and the governors-are year period, but the gov- drought-stricken grams can limit aid and ask the Senate to consid- on the same wavelength ernor's proposal would states met with U.S. Agri- be unclear in some er holding the agriculture for dealing with the allow farmers to receive culture Secretary Richard areas. appropriations bill from drought." those payments "up Lyng and congressional Assistance should go to the floor, so that it can South Dakota Gov. front." agriculture leaders this all farmers who have suf- be made compatible George S. Mickelson, lowa Gov. Terry E. week and agreed that fered crop losses, re- with drought assistance committee vice chairman, Branstad, chairman of Congress should move gardless of whether they legislation. stressed the importance NGA's Task Force on ahead quickly on com- grow "program" crops or North Dakota Gov. of providing cash flow re- Rural Development, said prehensive drought as- "non-program" crops. George A. Sinner, chair- lief to farmers. Gov. that Congress was sistance that will help all Program crops are crops man of NGA's Committee Mickelson has proposed "making a sincere effort farmers hurt by the such as wheat, which are on Agriculture and Rural a state program that to deal with the drought. covered by existing agri- Development, empha- would help farmers re- (drought) problem in an Participants in the cultural aid programs; sized the importance of structure their debts effective way." Other gov- meeting agreed that: non-program crops, such consensus on a "targeted through a federal conser- ernors attending were Governors and Con- as pinto beans and level of support" for vation reserve program Minnesota Gov. Rudy gress will work together tomatoes, are not cov- farmers suffering low (Bulletin, April 22). The Perpich, North Carolina to develop bipartisan ered under existing crop yields. "I want to be federal program pays Gov. James G. Martin, "core" legislation for programs. sure that everybody- farmers and ranchers to and Missouri Gov. John drought assistance, be- Aid to farmers may be the leadership in Con- take fragile farmland out Ashcroft. cause administrative lan- constrained by federal gress, the administration, of production for a 10- Continued on page 2 GOVERNORS' WEEKLY BULLETIN 2 Drug Abuse health organizations, local government, and law Continued from page I enforcement agencies. The group's philosophy is that long-term solu- innovative programs. Governors have helped de- tions to substance abuse are possible only velop interagency cooperation, community par- through the combined efforts of all major sectors ticipation, state-level training for programs, and in the community, supported by a collaborative multijurisdictional task forces. effort at the state level. Cooperation, Coordination. The level of coop- In January 1987, Kansas Gov. Mike Hayden eration and coordination among state, local, and launched Toward a Drug-Free Kansas, designed to federal agencies, within states, and between provide a comprehensive approach to alcohol and states, has increased substantially since passage drug education, prevention, treatment, and en- of the Anti-Drug Abuse Act of 1986. At least 17 forcement. Several state agencies provide re- states have created or expanded multijurisdic- sources and training for numerous community tional task forces, which allow a regional approach anti-drug abuse programs. to drug abuse and facilitate the sharing of person- The campaign has established a Regents Uni- nel, equipment, and information. versity Task Force on Drug Abuse, which has de- Minnesota has channeled all anti-drug abuse veloped a 26-point plan to reduce and prevent One of the most funds, for narcotics control, treatment, and educa- alcohol and drug abuse on college campuses by popular education tion, through a single coordinating agency, the providing substance abuse education and sup- State Planning Agency. Gov. Rudy Perpich's Inter- port services to college students. programs is DARE, Agency Task Force on Criminal Justice Policy sets which teaches policy in all three areas. The planning agency Drought Aid worked with other agencies to prepare an admin- students to avoid Continued from page I istrative spending plan for federal funds, consis- Other states were ministration support. "We drugs by building tent with task force policies. represented by lieuten- don't want legislation self-esteem and self- Like many other states' lead agencies, Rhode ant governors, agriculture just to talk about," said Island Gov. Edward D. DiPrete's Interagency Task commissioners, or gover- Leahy. "We want some- confidence. Force on Drugs involves groups such as the state nors' chiefs of staff, in- thing that's going to police, the attorney general's office, the Gover- cluding Indiana, Kansas, pass." nor's Justice Commission, the Governor's Office of Mississippi, Nebraska, Governors also Highway Safety, the state courts, the district attor- New York, Ohio, Tennes- pledged to help USDA see, and Vermont. ney's office, and the directors of state depart- provide clear language Agriculture Secretary ments of health, education, corrections, transpor- for assistance program Lyng said he would con- instruction. With other tation, children and families, and mental health, tinue to participate in bi- meeting participants, retardation, and hospitals. The state also has set partisan efforts to devel- they also discussed live- up a special court to handle drug-related cases. op drought assistance stock assistance, USDA Alabama's public safety department empha- legislation, and said he regulations on grazing or sizes stopping the spread of drugs, and Gov. Guy thought the President haying in conservation Hunt has increased the roles of the Alcoholic Bev- would sign legislation reserve areas, and the re- erage Control (ABC) Board and the Marine Police that is reasonable, com- lease and/or shipment of Division of the state conservation and natural re- passionate, and helpful. emergency water sources department in the war on drugs. In 1987, Senate Agriculture supplies. Committee Chairman the public safety department confiscated almost Participants also ap- Patrick Leahy (D-Vt.) and plauded Lyng's an- twice as much marijuana as it did the year before, House Agriculture Com- nouncement that all live- and total drug and property confiscations were up mittee Chairman Kika de stock farmers, whether or 138 percent. ABC agents have confiscated almost la Garza (D-Texas), who not they are in an offi- $17 million worth of drugs and property, and ma- attended the meeting cially designated drought rine police officers recently helped crack a drug with other members of a county, could participate smuggling operation in which $20 million worth of congressional task force in emergency feed assis- drugs and more than $400,000 worth of property on the drought, both em- tance programs. were confiscated. phasized the importance On June 23, governors of bipartisan cooperation from 10 states met with Community Groups. Besides coordinating the on a bill that can win ad- efforts of state agencies, states have also estab- Lyng in Chicago, III. lished organizations designed to encourage com- July 8, 1988 munities to support and develop anti-drug abuse Volume 22, Number 28 programs. Communities for a Drug-Free Colorado, Published weekly, except for one week in December and one week in August, by the National Governors' Association, 444 N. Capitol St. initiated by Gov. Roy Romer in 1987, is a three- N.W., Washington, D.C. 20001, (202) 624-5330. Opinions expressed year project to reduce substance abuse through- herein do not necessarily reflect NGA policy. Copyright 1988, out the state. Co-chaired by the governor and Pat National Governors' Association. Permission to reprint granted upon request. The Governors' Weekly Bulletin (ISSN 0888-8647) is Bowlen, owner of the Denver Broncos, the group provided at no cost to governors' offices. Subscriptions for state encourages the development of collaborative ef- officials are $50 a year, subscriptions for others are $75 a year. forts within communities that involve a broad New Hampshire Gov. John H. Sununu, Chairman range of public and private partners, including Raymond C. Scheppach, Executive Director Rae Young Bond, Director of Public Affairs schools, families, businesses, community groups, Alan Janesch, Managing Editor GOVERNORS' WEEKLY BULLETIN 3 Massachusetts Gov. Michael Dukakis organized wide. Participating agencies include the county the Governor's Alliance Against Drugs, a five-year district attorney's office, sheriff's department, plan, in December 1984. The alliance is a coordi- three city police departments, and the Milwaukee nated statewide effort to mobilize communities to Suburban Police Chiefs Association. address the problem of student alcohol and drug In Washington state, approximately $1.6 million abuse. More than 300 communities currently par- in federal funds in 1987 went to the state patrol's ticipate, and more than $2.2 million in cash and in- narcotics unit and crime laboratory system. An- kind contributions have been collected. Commu- other $1.6 million in federal funds went to local nities are asked to create school/community advi- units in the state. This funded 10 new regional, sory councils chaired by school superintendents. multijurisdictional task forces that target drug dis- Through the alliance, drug and alcohol programs tribution system and traffickers; a court program in have been sponsored by state agencies, major which visiting judges and pro-tem judges help media outlets, private health care providers, pro- local jurisdictions reduce backlogs of drug cases; fessional and amateur sports organizations, police training for law enforcement personnel in investi- associations, and private corporations. gation procedures and techniques; and training In Ohio, ONTASC (Ohio Network: Training and for prosecutors in asset forfeiture. Assistance for Schools and Communities) involves Other programs that states have implemented: skilled professionals from around the state who Eradication. Hawaii has undertaken a vigorous The governors have provide school and agency personnel with inno- program that eradicated $1 billion worth of mari- vative strategies to enhance the lives of youth. juana in 1987. Operation Green Harvest has coor- taken the lead in ONTASC uses teams of principals, teachers, par- dinated the work of state and local police across coordinating drug ents, law enforcement officers, substance abuse the state for several years. A new program, under abuse policy and specialists, and other school personnel. The pro- which marijuana plants are sprayed from hovering gram currently funds 37 programs for women and helicopters, involves the cooperation of numer- pooling state girls that emphasize networks with other agencies ous federal, state, and local agencies. The state resources for to provide outpatient treatment, residential treat- also recently launched a coordinated federal, comprehensive and ment, domestic violence shelters, and prevention state, and county drug interdiction program that and education. identifies methods used to ship drugs within the innovative Law Enforcement. State programs acknowl- state and to mainland destinations. programs. edge the extent of the drug abuse problem in both Education. One of the most popular education urban and rural areas, with special attention on programs in the country is DARE (Drug Abuse the large cities. But drug abuse and drug traffick- Resistance Education), taught by police officers to ing are regionwide problems and reach all parts of fifth and sixth grade students. The 17-week pro- the states, especially with the trans-shipment of gram, which was developed in Los Angeles in drugs within states and into other states. 1983, teaches students to avoid drugs by building States have recognized the toll that drug abuse self-esteem and self-confidence. The DARE pro- takes on rural areas as well as the large cities. In gram in Los Angeles has grown from 10 officers to Arkansas, for example, state treatment data indi- 80 who participate in every elementary school in cate that the number of admissions for drug abuse the city. treatment in 1986 was highest in the state's south- Illinois was the first state to implement DARE eastern region, which is heavily agricultural and statewide. Coordinated by the Illinois State Po- contains only one major city. lice, Board of Education, Department of Alco- One way that cities have benefited from federal holism and Substance Abuse, local educators, and anti-drug abuse funds is through grants to regional police officials, the state's pilot program involved task forces. For example, drug enforcement efforts 86 schools, representing 46 school districts and in Illinois are consolidated into the state police 8,500 students. Illinois officials also have led department, with Metropolitan Enforcement DARE training classes for officers from at least 11 Groups (MEGs) and task forces conducting local states as well. The state, which has instructed enforcement operations. A $1.47 million drug en- more than 170 officers, has been made a DARE forcement grant funded improvements at the Chi- regional training center. cago police department's crime laboratory, and Virginia's DARE program, begun as a pilot proj- $1.9 million was used to begin a multijurisdic- ect in 1986 and implemented statewide in 1987, tional prosecution program aimed at major drug was initiated by the state police in cooperation traffickers in the Chicago area. with the Department of Education and local law In Wisconsin, the Milwaukee County Metropoli- enforcement agencies. The program, in which 90 of tan Drug Enforcement Group was awarded $392,- 134 school districts participated in the past year, 939 of the $2.2 million in federal dollars for en- has reached a total of 134,000 fifth- and sixth- forcement available to governmental units in the graders to date. state in fiscal 1987. With state and local matches, Prevention. In February 1988, Alabama Gov. the group received a total of $523,919, which will Hunt sponsored the state's first Governor's Con- be used to identify, investigate, prosecute, and ference on Drug Awareness, which provided more convict major drug dealers and to reduce con- than 2,000 young people and adults with current trolled substances available in the Milwaukee metropolitan area and, as a result, available state- Continued on page 4 GOVERNORS WEEKLY BULLETIN 4 P olicy Deadlines. Pro- of the staff work on proj- Drug Abuse Briefly posed policy state- ects where there is signif- Continued from page 3 ments that individual icant similarity with busi- information on drug abuse. In an attempt to offer Stated governors want to have ness activities and every young citizen in the state the same informa- considered at NGA's Aug. technology:" Examples: tion, Gov. Hunt is also sponsoring regional confer 6-9 annual meeting have procurement, motor vehi- ences in rural areas. been submitted to NGA cle maintenance, and Colorado's Communities for a Drug-Free Colo- and are being reviewed printing. Gov. Celeste's remarks were included in rado uses a combination of prevention strat- by the appropriate standing committees. In proceedings of a confer- egies, including curriculums for kindergarten to accordance with NGA ence held by the Center 12th grade students, programs for higher éduca- rules, committee policy for Urban and Public Af- tion, alternative activities, information, peer statements will be trans- fairs at Wright State Uni- leadership, early intervention, and referral mitted to all governors versity in Dayton, Ohio. programs. by no later than July 25- I nnovation Meeting. Treatment. South Dakota Gov. George at least 15 days before Winners of national Mickelson's office is working with the State the meeting's closing awards for innovation in Board of Charities and Corrections to develop a plenary session, to be state and local govern- statewide program for chemical dependency held on Aug. 9. ment will meet Nov. 9-11 treatment and counseling in the correctional sys- L oaned Executives. for an innovations confer- tem. When the program is fully implemented, Working partnerships ence in Australia and each correctional facility will have an accredited with the private sector New Zealand. Co-spon- chemical dependency program. are the key to the suc- sored by the Academy cess of many major state for State and Local Gov- The Colorado health department's alcohol and initiatives, Ohio Gov. ernment's International drug abuse division licenses approximately 150 Richard F. Celeste said at Center and the Australian public and private substance abuse programs in a conference on loaned Local Government Asso- the state. The division contracts with 38 communi- executives. "Those of us ciation, the conference ty agencies to provide a range of services focusing in state government will include panel ses- on three populations-low-income persons who should make more effort sions on human services, could not otherwise afford treatment, chronic se- to draw upon the tre- education, and training; vere and socially unstable individuals who cannot mendous wealth of ex- infrastructure and trans- afford or access private treatment, and publicly pertise, resources of ex- portation; pollution con- intoxicated persons who can be taken to a non- perience, and trol; and local economic understanding that exist development. Also hospital detoxification facility for withdrawal, eval- in private busi- scheduled are sessions uation, and referral. nesses," said Gov. Celes- on the innovation trans- In fiscal 1988, the Massachusetts public health te. "I encourage the de- fer process and the fos- departments alcohol and rehabilitation division velopment of ongoing tering of an organiza- funded 385 residential and ambulatory programs. loaned executive pro- tional climate that Ninety-six percent of the divisions' funding goes grams." A guide from the encourages innovation in to direct service, including alcohol and drug de- Coalition to Improve the delivery of public toxification, halfway houses and therapeutic com- Management in State services. Other meetings munities, ambulatory and residential youth pro- and Local Government, and site visits will be to which NGA lent its co- held between Nov. 2-14. grams, outpatient counseling, methadone ser- operation, says that loan- For more information, vices, driving under the influence programs, and ed executives can per- contact the center, (202) prevention training programs. form "a substantial part 638-1445. Mark Miller is an editor in NGA's public affairs office. GVERNORS WEEKLY BULLETIN National Governors' Association Hall of the States 444 North Capitol Street Washington. D.C. 20001 On the Inside States Step Up Attack On Nation's Drug Problem Governors Review Recommendations To Aid Drought-Stricken States ADDRESS CORRECTION REQUESTED A HISTORY ON NGA INVOLVEMENT IN DRUG ISSUE In the summer of 1982, NGA adopted the first policy on drug control, calling for a national strategy with federal involvement. In the fall 1982, NGA along with the National Criminal Justice Association (NCJA) convened an ad hoc group of Governors' staff, state policymakers and state law enforcement officials to assess states' drug control needs and to deliberate a state role in the national drug control strategy. Also in the fall of 1982, the Reagan Administration issued a status report on the national drug control effort, calling for an increased intergovernmental cooperation and the creation of formal relationship with NGA through a "Governors' Project". In the fall of 1983, NGA with the NCJA conducted a special seminar on the use of the military in drug control, and issued a final report calling for increased assistance from the Department of Defense and an enhanced role for the National Guard. In the winter of 1983, a special session on drug abuse issues was held at the NGA winter meeting with the Attorney General, the Director of the FBI and the DEA. NGA adopted a National drug control policy. As a part of the "Governors' Project", a grant was received from the Department of Justice to conduct an extensive study of state drug control laws and procedures which resulted in a special report on state drug laws. The study was conducted by the NCJA from spring 1984 through summer 1985. In the fall of 1985 through summer 1988, NCJA conducted a project to develop self-help instructional curriculum on assets seizure and forfeiture for state implementation. Pilot programs were conducted in Maryland and Illinois. In the winter of 1986 through spring 1987, NCJA with NGA participation, conducted a regional seminar series in several states on legislative options for drug laws enforcement. In the winter 1986 through winter 1987, NCJA conducted a study of controlled substances acts. A guide for states was released. In the fall of 1987, NGA and NCJA commenced a two-year project to develop information for states on options for treating drug-dependent offenders. *The National Criminal Justice Association serves as staff for the Committee on Justice and Public Safety. 3/3/89 THE white HOUSE washington SENATE JuDiciARy CommiTTEE Strom Thumond: Cooney DEATH penalty \ BARNA Day 233-4000 233-274 # 900 9861 MIX TASK FORCE ON ALCOHOL AND DRUG ABUSE CHAIR T he problems of drug and alcohol abuse are problems of shattered lives MARTHA LAYNE COLLINS and wasted opportunities. They are indi- Governor of Kentucky vidual in nature, yet public in their effects. The victims suffer the despair of de- cline and dependence: some 127,385 die every year (Fein 1984). Their families suf- TASK FORCE MEMBERS fer turmoil and pain. Some cannot hold together under the strain. Others suffer grief at the loss of a son or daughter. a STEVE COWPER husband or wife, a brother or sister. Governor of Alaska The public pays directly in higher EVAN MECHAM health care costs, lost productivity in the Governor of Arizona economy and in more money for law en- forcement; it pays indirectly because drug TERRY BRANSTAD and alcohol addiction strike at the very Governor of Iou'a heart of society's resilience today and its JAMES J. BLANCHARD potential for tomorrow. Governor of Michigan The magnitude of these problems of individual suffering and public loss is TED SCHWINDEN clear in the numbers. Sixty percent of all Governor of Montana illegal drugs produced in the world are JAMES G. MARTIN consumed in the United States (de Bernar- Governor of North Carolina do 1987). A 1986 CBS News poll indicated that about two-thirds of the public viewed RAFAEL HERNANDEZ-COLON drugs as a serious problem in their com- Governor of Puerto Rico munities, and in a 1984 Roper opinion EDWARD D. DiPRETE poll drugs and crime were ranked as the Governor of Rhode Island problems Americans most wanted gov- ernment to address (Carroll 1985). More NED RAY McWHERTER than $110 billion is grossed annually from Governor of Tennessee the illegal sale of drugs-more than the WILLIAM P. CLEMENTS JR. total American farmers earn for all crops Governor of Texas and more than double the combined profits of all Fortune 500 Companies (de TOMMY THOMPSON Bernardo 1987). Governor of Wisconsin Nearly 96 million men and women- more than two-thirds of the nation's adult population-use alcoholic beverages. Most have learned to use these beverages without ill effects. However, roughly 10 million people have become problem drinkers or alcoholics (Fein 1984). Alcoholism affects more than one-third of the nation's families, with devastating effects. Research has shown that: Children raised by alcoholic parents are four times more likely to become alco- holics than children from non-alcoholic homes. PAGE 98 Thirty-seven percent of children whose Sixty-five percent of those entering the parents were alcoholics grew up to he- full-time workforce for the first time have come alcoholics and 21 percent of them used illegal drugs. and about 10 percent the workforce has alcohol or drug abuse married alcoholics. problems, which results in a 25 percent 10 50 percent loss in productivity (de Bernar- Adult children of alcoholics were twice do 1987). as likely [() experience depression or other mental health problems. While the Twenty percent of the annual national impact on individuals is often tragic. the expenditure for hospital care and 12 per- costs to their unborn children, their fami- cent of the national health expenditures lies. and to society as a whole are even for adults derives directly from alcohol more staggering. (Fein 1984) abuse (Fein 1984). Impact on Young People Blue Cross of Greater Philadelphia stud ied 311,000 employees and found that al- What makes the drug and alcohol prob- cohol and other substance abusers used lem even more alarming is its effect on young people-the very future of society: technically legal to use. "Crack." which is a eight times as many hospital days as other Drunken driving is the leading cause of highly addictive form of smokable co- workers did (Blue Cross 1981), death among those fifteen to twenty-five caine, has recently become one of the years of age (National PTA Bulletin 1986). most frequently used drugs in many ma- In many schools. drug and alcohol use has jor cities because it is cheap and readily reached epidemic proportions. A chil- available. drens magazine found that one-third of In 1982, almost 10,000 people suffered fourth graders it surveyed reported heroin overdoses and were admitted to "some" to "a lot" of pressure to drink emergency rooms in 820 hospitals in met- alcoholic beverages (National Institute on ropolitan areas (Graham 1985). There is Drug Abuse 1984). And student leaders also a major problem with the misuse of report that teenage alcohol use is the sin- legally prescribed drugs. It has been esti- gle biggest problem facing schools mated that in some states the diversion or (National PTA Bulletin 1986). misuse of prescription drugs constitutes Furthermore, 62 percent of American more than half the drug problem. high school seniors try an illicit drug be- fore they finish high school. one in twenty The Cost to Society high school seniors smoke marijuana and/or drink alcohol daily, and about 40 The tremendous amount of human suffer- percent of these seniors have used illicit ing implied in these statistics is obvious. drugs other than marijuana (National PTA What is sometimes overlooked is the phe- Bulletin 1986). There is a relationship be- nomenal cost of this suffering in dollars tween drug and alcohol use and the high and cents. For example: school dropout problem. In a Philadel- phia study, dropouts were almost twice as Drug abuse costs American business likely to be frequent drug users as were more than $60 billion a year in lost pro- high school graduates: four in five drop- ductivity, increased absenteeism, work- outs used drugs regularly (U.S. place accidents, rising medical costs, and Department of Education 1986). theft (de Bernardo 1987). New drugs appear regularly The so- called "designer drugs," which are made by producing slight changes in the chem- ical formula for controlled substances, are growing in popularity because they are PAGE 99 & The Governor's Role support from the Governor the success of and alco olabuse prevention plan of action. The Governor's commitment to working Of persons jailed for violent crime. 54 The drug problem has taken still an- long-term sol percent admit having been "pretty drunk" other serious turn recently with the dis- concerted action on a variety of or "very drunk" when the crime was com- covery that acquired immune deficiency fronts is essential. mitted (Bureau of Justice Statistics. January syndrome (AIDS) is transmitted through When state school 1983). the sharing of needles by intravenous systems, business and industry, drug users. It has been estimated that ap- and the forcement Of prison inmates interviewed in a Ken- proximately 25 percent of the intravenous community canagree on tucky Corrections Department study: 71 drug users in New York City carry the specific strategies to combat the percent admitted drug or alcohol depen- AIDS virus (National Institute on Drug drug abuse problem, the dency (Carroll 1985). Abuse 1987). Governor can be the guiding The seriousness of the drug and alco- force in reducing barrier to Forty-eight percent of all crimes (vio- hol problem calls for nothing less than a the nation's individual and lent and non-violent) were committed total commitment from all levels of gov- collective productivity. while "under the influence" (Bureau of ernment to develop solutions. The solu- Justice Statistics, March 1983). tions must move beyond providing aid or treatment for those individuals who have Fetal alcohol syndrome, a set of birth already developed alcohol and drug prob- defects caused by consumption of alcohol lems. They should focus on prevention during pregnancy, is the third leading strategies and recognize that many alco- known cause of mental retardation, cost- hol- and drug-related problems besides ing at least $800,000 per child over his/her dependence and addiction require atten- lifetime (National Institute on Drug Abuse tion. This means that it is necessary to 1983). develop a comprehensive strategy de- signed to: Delay the onset of the use of mind- altering substances, since early and heavy involvement is a predictor of later The Governor has established a Communities for a Drug Free Colora- problems. do program, which will focus on community-based education and intervention activities. The Governor's Executive Council coordinates Reduce health and situational problems the program in an effort to stimulate and motivate the collaboration that are directly related to the use of sub- of private, public, and media resources to reduce substance abuse in stances. such as drinking and driving, fetal Colorado. The program will establish a statewide community part- alcohol syndrome, and cirrhosis. nership program in which Colorado's communities, parents, young people, and school districts work cooperatively to prevent and reduce Increase early detection of alcohol and the illicit use and harmful effects of alcohol and drugs among youth. drug problems at a point when treatment The program will emphasize public-private partnerships. Key lead- may be less costly and have a higher prob- ers at state and local levels will be recruited to work with youth, ability of success. family, and school systems to plan and develop prevention and intervention programs. Community meetings will be held and com- Treat and restore the health and social munity training teams will be selected. The teams will be trained in functioning of individuals who are depen- team building, action planning, resource development, and other key dent on alcohol and other drugs. areas, and will develop comprehensive programs to prevent and treat substance abuse. A variety of support services will be initiated, Although drug and alcohol problems including an information clearinghouse, technical assistance and may never be totally eliminated, there is grants, public relations assistance, an ongoing incentive program, much that can be done, and the develop- and program evaluation. ment of a strategy to tackle the problem is essential. PAGE 100 ELEMENTS OF A STRATEGY S uccessful approaches to drug and alco- hol problems require commitments to long-term and comprehensive program- ming. Prevention strategies must be aimed at reducing supply and demand. In order to be truly comprehensive. a state action plan to reduce substance abuse problems should have several characteristics. First. drug and alcohol programming must reach all sectors of society. Besides programming aimed at the general pub- lic, strategies must be tailored to meet the special needs of minorities, women, chil- dren, and the elderly. The planning pro- cess should identify populations that are at high risk. Planning should recognize that programs that are highly successful with one target population (e.g., teenagers) may not be appropriate for another (e.g., younger children). Second. all key community groups should be actively involved in both plan- ning and implementation. Every citizen Champions Against Drugs is a cooperative effort between the state has a role to play and should be encour- and local governments, working with the private sector. The Governor aged to assume responsibility for his or has begun a prevention effort of public education and a community her part in the solution, whether it be as mobilization campaign. The public education program uses well- an employee, employer, parent, friend, re- known Kentucky athletes and citizens who speak out against alcohol ligious leader. politician, school adminis- and drug abuse. At the same time, the program encourages citizen trator, policeman. teacher, judge, or social involvement. The program uses a comprehensive four-pronged ap- worker. State plans should encourage proach: public awareness; education and training (with a special widespread citizen involvement. emphasis on youth leadership training); intervention and treatment; Any overall strategy should include: and law enforcement. A statewide council and seventeen regional public awareness and education, training action groups are working together to develop comprehensive strat- and professional development, interven- egies to address alcohol and drug problems at the state, regional, and tion and treatment, and interdiction and community levels. Champions has led to the creation of active citizen law enforcement. groups in sixty communities in the state, all supporting programs to prevent the spread of drugs. Fifty "Just Say No" clubs also have been formed to promote drug-free activities and positive peer pressure. The program has unveiled a collector card series, featuring sports stars and celebrities, that carries an individual message about sub- stance abuse. Law enforcement officials will use the cards as a way to discuss substance abuse and prevention. Since Champions began in September 1986, eight major anti-drug rallies have been held in the state and seven more are planned. Sixteen public hearings are also planned statewide by Champions to prepare recommendations and a legislative packet for presentation to lawmakers of the 1988 Kentucky general assembly. PAGE 101 Public Awarenes and Education IOWA Although the terms "awareness" an The Governor has established the Governor's Alliance on Drug Abuse "education" are often used synonymousl with a comprehensive three-point program including: drug educa- they represent two discrete strategie tion, treatment, and prevention; tougher penalties for drug pushers; Awareness efforts seek to alert the publ: and stronger enforcement of drug laws. In October 1986, eight to the risks associated with drug and alce correctional facilities were opened for individuals convicted of drunk hol use. Awareness efforts can also teac driving. These facilities offer a combination of treatment, supervised wavs to reduce the risk of drug and alce living, and employment opportunities. hol problems, and let the public kno about prevention, intervention, and trea ment programs. NEW IERSE Education programs generally ar more structured, last longer. and attem] The Governor is calling for the creation of an Alliance for a Drug Free to develop skills, increase knowledge. an New Jersey. The alliance calls for business, law enforcement, re- change attitudes. They often have an ult ligious, education, and community leaders to establish a statewide mate goal of changing behavior. program against substance abuse. It plans to solicit New Jersey's 567 Research has demonstrated that aware cities and towns in an effort to abolish drug abuse. The initiative will: ness and education strategies are essenti: organize and coordinate the efforts of schools, police, business ingredients for prevention. This researc groups, and other community organizations to fight drug abuse; has begun to identify some effective pre adopt comprehensive, effective drug abuse education programs in the vention strategies. schools, beginning in kindergarten and continuing through high For example, these programs must: school; adopt clear procedures for the intervention, treatment, and discipline of students abusing alcohol and drugs; provide a compre- Be comprehensive and intensive i hensive drug abuse education and outreach program for parents; and nature, begin early and continue throug provide a comprehensive substance abuse community awareness a lifetime, and be targeted to the tot: program. community The program focuses heavily on the demand side, and seeks to provide drug abuse education to every child in the New Jersey public Be aimed at specific attitudes about a school system. The program focuses on prevention, intervention, and cohol and drugs, and at developing gener treatment. Prevention programs are geared toward limiting the de- al life skills, such as assertiveness, pee mand for drugs through increased public awareness, community resistance, problem-solving, communic: activity and parental support. Intervention programs seek to identify tion, and critical thinking. drug abusers at the earliest point and encourage their participation in an appropriate treatment program. The most important aspect Target all youth and develop specialize however, is the education, treatment, and rehabilitation of the young strategies for those who are high-risk, e.g people of New Jersey. school dropouts and those who have mental health problems or who are eco nomically disadvantaged. Integrate prevention activities into fam: ly, school, and community life. Studies are in progress on a number school curriculums and community edu cation programs. Preliminary results an encouraging, but much more information is needed. A comprehensive state plai should recognize what is known abou PAGE 102 "I see in my practice and in my recovery meetings each week the unbelievable influence of chemical dependency. To bring it into focus, there are about 300 people in this room. Ten to program effectiveness, seek reliable data nity and parents through advisory and co- fifteen percent of you are on programs that might be implemented, ordinating bodies. chemically dependent. That and include provisions to promote and means that thirty to forty-five of apply continued research. Colleges and universities should devel- you are chemically dependent, A comprehensive plan will also recog- op comprehensive campus alcohol and you are alcobolics or drug nize that education programs are needed drug programs. This can include adopting addicts. Each of you will by adults as well as children. Some of the effective enforcement policies; incorpo- directly influence four other most notable achievements in prevention rating alcohol and drug education into the lives. That means that 120 to today are occurring in part as a result of general education curriculum; providing 180 people will be directly health messages being targeted to the ongoing campus awareness programs: affected as a result of this adult population. For example, per capita and identifying and referring for treat- chemical dependency. Not only consumption of alcohol has declined con- ment students, faculty, and staff who have will you not be able to work sistently over the past three years. A 1985 alcohol and drug problems. but you won't be able to live. Gallup survey found that 14 percent of all State and local coalitions and agencies That is a real overwbelming adults planned to decrease their drinking should provide substance abuse educa- and overpowering within the next year and 2 percent tion programs for adults in a variety of realization." planned to quit altogether. In addition, settings, including workplaces, religious beverages with a lower alcohol content institutions, health care facilities, civic or- BURNS BRADY, M.D. appear to be gaining in popularity. Kentucky ganizations, and community centers. A comprehensive plan also recognizes State departments of health and state that education programs for all ages can medical associations should encourage be provided in a variety of settings besides health departments, prenatal clinics, and schools, including workplaces, religious An alcohol and drug abuse prevention obstetricians and gynecologists to provide institutions, civic organizations, health curriculum that begins in kindergarten information and education about the risks care facilities, and community centers. and continues through high school, and of alcohol and drug use during pregnancy that is based on research and aimed at and lactation. behavioral changes. Peer resistance skills State government should form a part- Alliances for Education. State depart- ments of education and alcohol and drug training should be an integral component nership with universities to identify and agencies should form alliances with state- of the curriculum. appropriate funds for research to deter- mine the causes and conditions of sub- wide education associations and other Ongoing alcohol and substance abuse stance abuse, as well as the effectiveness of groups to encourage and reinforce the education and training for faculty and staff. prevention strategies. This partnership development of comprehensive pro- should also address the dissemination of grams for youth in local schools and to advocate a stable funding base that en- Education for parents that provides al- these research findings so they can be sures adequate resources are available to cohol and drug information and parent- used by state and local groups. Television and radio stations and the local schools and communities. ing skills. press should be encouraged to contribute School boards should be encouraged to develop comprehensive alcohol and Peer education programs and leader- their services toward public awareness ef- forts. In fact, states may support federal drug programs that consist of: ship programs. action to require the media to apply an Identification, intervention, and referral equal time doctrine to alcohol advertis- A policy that clearly articulates the schools' response to possession of alcohol services for students, faculty, and staff who ing. This would include the airing of and other drugs by students and staff, have alcohol and other drug problems. health messages, produced by indepen- dent health groups, on an equal basis with which is communicated to the schools Strategies to educate and involve the alcohol advertising. The media can be a and larger community and is consistently larger community such as law enforce- powerful ally in awareness and education enforced. ment, civic and service organizations, and campaigns. parent groups in a partnership for preven- tion. Such programs must be planned and carried out with input from the commu- PAGE 103 State education departments, alcobol and drug agencies, education associations, and other groups should form alliances to develop comprebensive substance abuse programs in local tively with clients. Prevention profession- schools. It is also important to als must also acquire specialized knowl- advocate a stable funding edge and skills. Developing competence structure that ensures that in both treatment and prevention is essen- adequate resources are available to local schools and tial to progress in the drug and alcohol abuse field. communities. Elements that can be included in devel- oping an effective strategy include encour- aging state higher education authorities. professional licensure boards, and profes- social services, religion, and health, are in sional associations to work together to key positions to identify and refer citizens develop preparatory education and con- who have alcohol and drug problems to tinuing education for: education and treatment programs. Train- ing is needed for these key professional school administrators, teachers. and groups so they have the information and counselors; skills to detect possible substance abuse Training and Professional and to encourage individuals to seek help. law enforcement and criminal justice Development These key groups can be reached personnel; through special information brochures Professionals in the human services field on alcohol and drug abuse treatment pro- physicians, nurses, pharmacists. and often deal with problems that involve grams that can be given to clients; drug other health care personnel; drug and alcohol abuse. More often these and alcohol abuse workshops offered dur- professionals see only the results of the ing professional meetings and confer- social workers; and chemical abuse problem (e.g., child ences; and by integrating courses on alco- abuse, marital discord, poor health, and hol and drug abuse into preparatory clergy and other religious leaders. failing grades in school) and do not recog- curriculums for these professions. nize drug and alcohol dependence as the Professional development is also a crit- Such education should allow for an client's primary problem. Professionals, ical need within the substance abuse pro- understanding of alcohol and drug abuse. particularly in education, criminal justice, fession. There is a lack of professionals detection and recognition of substance who are qualified in both prevention and abusers, referral for treatment, and ex- treatment. Mental health professionals are posure to effective prevention regularly called upon to provide counsel- approaches. ing for substance abusers. A mental health States can also develop formal mecha- professional who has not been trained in nisms to ensure minimum competence drug and alcohol abuse treatment may and ethical practices by those who pro- often fail to diagnose the client's substance vide alcohol and drug prevention and abuse problem. Drug and alcohol treat- treatment services. These mechanisms ment uses special techniques that must be should define and promote a common learned if professionals are to work effec- body of knowledge and skills, develop academic training groups for prevention and treatment professionals, and ensure the quality of services. State governments should work coop- eratively with appropriate statewide asso- ciations and organizations to ensure that judges, prosecuting attorneys, and proba- tion, parole, and law enforcement officers receive ongoing training about alcohol and drug abuse and their roles in address- ing these problems. PAGE 104 Drug abuse costs American business more than billion in oductivity increased absenteeism, place accidents, rising medical costs, and tbeft. Intervention and Treatment must often travel great distances or change their place of residence to obtain the ser- Intervention and treatment resources are vices they need. Treatment programs for percent of an integral part of any comprehensive ac- adolescents and other populations with entering the full-time tion plan. Prevention education and special needs, e.g., women, minorities, se- tbe first time awareness programs help communities nior citizens, the homeless, are in great understand the need for drug and alcohol demand. Services should include a family about 10 p ercento the treatment services. Effective prevention resource component, inpatient and out- wor programs also give professionals the patient treatment, and long-term residen- problems which knowledge and skills to identify clients tial programs. percent to who have drug and alcohol problems. loss in uctivity. Self-help groups such as Alcoholics Anonymous have helped millions of sub- Attention to Funding. Attention to stance abusers. However, they do not pro- funding in this area is essential, and addi- A compi vide the total answer. Very often interven- tional commitment of state funds is often sbould recognize tion and treatment is needed to prepare needed. In addition, insurance coverage known about the dependent person to accept what a must be sought where it is not currently effectiveness reliable self-help group can offer. Many persons provided. Both private insurance and data on programs who desperately need treatment are not Medicaid reimbursements are appropri- be implemented and include able to recognize the problem in them- ate funding sources. Studies show that provisions to promote selves and will not voluntarily join a self- treatment is cost-effective. Drug and alco- apply continued research. hol abusers who have not received treat- help group. Intervention is a process of identifying a person's substance abuse problem, com- municating effectively with the individual about the problem, and encouraging the person to enter treatment if necessary. Community settings where drug and alco- hol problems tend to surface are ideal ARKANSAS locations for intervention. Drug-related problems often present themselves in The Governor recently announced the establishment of a pro- schools (where students experience fessorship on alcohol and drug abuse prevention and an endowed school failure or discipline problems re- chair on alcoholism and drug abuse studies at the University of sulting from their use of substances), so- Arkansas for Medical Sciences. The professorship was funded cial service agencies (spouse and child through a grant from the Arkansas Department of Human Services abuse), health care facilities (medical Alcohol and Drug Abuse Prevention Division (OADAP). The endowed problems resulting from abuse), welfare chair will be funded through a challenge grant from the same agency and other benefit agencies (where alco- and through funds raised from a temporary alcoholic beverage tax hol and drug problems may contribute to passed by the legislature. the failure to seek and maintain a job), and In addition, OADAP funds and supervises school- and community- in the workplace (where evidence of alco- based programs in the areas of primary prevention and drug and hol and drug problems is seen in absen- alcohol abuse education. Efforts are made to involve youth in all teeism, increased sick leave and health project planning and implementation. All programs are encouraged insurance claims, accidents and de- to recruit volunteers and community participation is heavily weighed creased productivity). For effective inter- when programs-are selected for funding. vention, adequate treatment resources must be available in the community. At present, most communities do not have a full range of drug and alcohol inter- vention and treatment services. Clients PAGE 105 a Many communities have discovered that a partnership between schools, treatment centers, parents, social workers, and criminal justice professionals has been a particularly effective way to identify and refer individuals. If proper resources are invested in pre- Agency Outreach. Policies and proce- Stepped up enforcement.of vention and early intervention, the payoff dures of existing health and social service laws and penalties for could be increased tax revenues, greater delivery systems should be reviewed to drunk driving for example, productivity, and a healthier citizenry. determine their potential for identifying have resulted in eased A successful strategy to prevent drug and referring clients for treatment of alco- referrals to alcobo abuse and alcohol abuse must include a variety hol and drug problems. education programs. of elements. Staff who interview clients for unem- ployment compensation, AFDC, or other Cooperation in Government. State ex- benefits should be trained to detect possi- ecutive and legislative branches of govern- ble drug and alcohol abusers and to refer ment drive up insurance costs by seeking ment should work cooperatively to allo- them to treatment. Staff in public health treatment for other ailments caused by cate adequate resources for the treatment clinics, particularly those offering prenatal their substance abuse. and rehabilitation of drug- and alcohol- services, should be trained as well. In allocating resources, it is important dependent citizens. Agencies that provide child abuse and to keep in mind the tremendous costs of Special attention must be given to pop- neglect services should screen for paren- drug and alcohol abuse. Mechanisms to ulations in greatest need and those who tal alcohol and drug abuse and develop identify those who are abusing, to inter- traditionally have been underserved. An a family service plan that includes vene, and to provide effective treatment adequate range of specialized treatment treatment. have great potential for reducing the total services needs to be available and accessi- costs to society. ble to adolescents. This should include Business Cooperation. State depart- Employee assistance programs in the inpatient and residential services, family ments of commerce and labor and labor workplace or student assistance programs counseling, and outpatient transition care management groups should promote and in schools and colleges are examples of and aftercare to support recovery. support the efforts of business and indus- early intervention programs that can save Attention also should be given to indi- try to develop employee assistance pro- millions of dollars. These programs are viduals in shelters for the homeless, since grams that identify and refer troubled em- cost-effective because employee or stu- experience suggests that they have signifi- ployees for treatment. States may wish to dent "downtime" is reduced, health care cant alcohol and drug problems. explore tax incentives for businesses that costs are controlled, and highly trained States should explore the possibility of implement such programs. employees or very bright students are re- changing laws that provide and regulate tained. For example, in 1984 an employee private and public health insurance to en- Criminal Justice Response. States assistance program jointly administered sure that adequate and reasonable cover- should conduct a thorough review of the by AT&T and the Communication Workers age for the treatment of alcohol and other criminal justice system's response to alco- of America cost the company $1.3 million, drug problems is available. Laws may be hol and drug abuse to determine the ade- but saved the company $3.3 million (de formulated to facilitate coverage for treat- quacy of diversion and treatment options. Bernardo 1987). The Commonwealth of ment in the most cost-effective and appro- Based on the findings, states may consider Pennsylvania also has a program to help priate setting, whether it be free-standing the following steps to increase their po- state employees with their substance or hospital-based, inpatient or outpatient, tential to provide treatment for individuals abuse problems. public or private. who have alcohol and drug problems. States should also explore alternative Any individual who is detained for a funding strategies, including Medicaid, to criminal offense pending trial should be provide the most cost-effective coverage screened for alcohol and drug problems for treating alcohol and drug-dependent and referred to appropriate treatment. adolescents and adults in an appropriate States should develop adequate alcohol and efficient setting to meet individual and drug treatment programs for con- needs. victed felons. Treatment programs should be available to the offender within the correctional institution before the individ- ual returns to the community. Participa- tion in a community-based treatment pro- gram may be made a condition of PAGE 106 "Amy ran our family wben she was addicted to drugs My father died from cancer-it took two years for bim to die and it was a very painful thing for me but it wasn't nearly as bad as watching my daughter probation. Such treatment can substan- die spiritually." tially reduce the number of repeat of- LOUIS FREEMAN fenses for those crimes directly related to Ohio alcohol and/or drug dependence. Judges should require parents sus- pected of child abuse or neglect or other domestic violence to be assessed for drug States should cooperate and assist the and alcohol problems. When a drug or federal government whenever possible alcohol problem is found, treatment with interdiction. A unified effort of en- could be required. forcement is necessary to help the federal Criminal justice services and other ju- government carry out its responsibility. venile service providers should work CO- operatively to identify, intervene, and pro- Identifying Offenders. In addition to vide appropriate education, treatment, interdicting the supply of drugs and and follow-up for all youth identified punishing drug offenders, the criminal through the courts as having alcohol and justice system can also identify and help drug problems. offenders who need drug and alcohol Attention also must be paid to the prob- treatment. Judges, attorneys, parole offi- lem of substance abusers in state prison Interdiction and Law cers, and police are in key positions to systems. A recent study completed by the identify both youth and adult offenders Enforcement Kentucky Department of Corrections who have drug and alcohol problems. shows that 71 percent of prison inmates Effective law enforcement is an important One national program available in identified themselves as alcohol- or drug- influence in both the supply and the de- many communities is aimed at treating dependent (Carroll 1985). Programs to mand for drugs. Drug dealers participate criminal offenders who are substance rehabilitate these offenders before they in an illegal business that uses many of the abusers. Treatment Alternative to Street are released and provide appropriate fol- same techniques of legitimate businesses. Crime (TASC) is funded through the U.S. low-up afterward have the potential to The streets are the marketplace and all Department of Justice with state and local greatly reduce recidivism. individuals are potential customers. matching funds. This program attempts to Enforcement of the minimum drinking In attempts to control drug sales in bring together the justice system, with its age is another area where law enforce- neighborhoods around the nation, law legal sanctions that reflect concerns for ment efforts are critical. Public support for enforcement officials rely on several tools: public safety and punishment, and the strict enforcement is growing. Parents are sentencing, forfeiture of assets, electronic treatment community, with its emphasis gaining greater appreciation of the ra- surveillance, witness immunity and pro- on therapeutic relationships that change tionale behind this law: drunk driving is the individual behavior of substance tection, and reviewing currency transac- the leading cause of death among young tion reports and state revenue files. Any abusers. Under TASC, community-based people, and raising the drinking age has efforts to strengthen and facilitate the use treatment is made available to drug-de- been correlated with a reduction in these of these tools will enhance law enforce- pendent individuals who would other- fatalities. Public education about other ment efforts. Some 708,400 suspects were wise burden the community and the jus- correlates of youthful drinking (van- arrested on drug charges in 1984 (de Ber- tice system with their criminal activities. dalism, teenage pregnancy, other drug nardo 1987). Many communities across the nation abuse, school failure) has also increased One of the major law enforcement have discovered that a partnership be- support for effective enforcement efforts. problems is trying to get a handle on the tween schools, treatment centers, parents, amount of drugs entering the United social workers, and criminal justice pro- States. Approximately 12 tons of heroin, 65 fessionals has been a particularly effective tons of marijuana, and 150 tons of cocaine way to identify and refer individuals. entered the United States in 1986 (de Ber- Stepped-up enforcement of laws and nardo 1987). Preventing drugs from enter- penalties for drunk driving for example, ing the country is a federal responsibility. have resulted in increased referrals to al- The nation's borders must be patrolled for cohol abuse education programs, which all types of contraband, most of all drugs. in turn has helped identify drug and alco- hol problems in many offenders. PAGE 107 The seriousness of the drug and alcobol problem calls for nothing less than a total commitment from all levels of government to develop solutions. Enforcing Laws, Stopping Supplies. More aggressive investigation and pros- An effective state strategy to enforce drug ecution of drug traffickers. Prevention strategies must be laws and stop the drug supply should in- aimed at reducing supply and clude several elements. A 1985 report on Greater resource commitments to drug demand. State Laws and Procedures Affecting Drug law enforcement initiatives. Trafficking Control by the National Crimi- nal Justice Association and the National Greater uniformity among state laws af- Governors' Association calls for: fecting the nature and extent of enforce- Drunk driving is the leading ment activities, prosecutorial procedures. cause of death among fifteen- Greater coordination among law en- and penalities imposed on individuals to twenty-five-year-olds. forcement agencies at all levels of govern- convicted of violating applicable laws. ment. Governors should commission law en- forcement task forces to study ways to improve the legal tools available for inter- diction and prosecution. States should adopt policies and proce- MISSOURI dures that control the diversion of pre- scription drugs through a centralized re- The Governor recently announced a six-part drug and alcohol abuse porting system. prevention/initiative designed to forge a partnership between state Laws setting the minimum drinking and local groups The plan, called 'MO says NO to Alcohol and Drug age should be aggressively and consis- Abuse provides a coordinated response to the problem of substance tently enforced, especially at events where abuse in the state: Among the initiative goals an e to: create local underage drinking is most likely to occur, responses to local: problems by forging a partnership between such as rock concerts, sporting events. schools and community groups; teach students about the dangers of and establishments that cater to a younger alcohol and drug abuse by improving the alcohol and drug abuse adult or mixed-age clientele. curriculum; and identify and treat young people: with substance States also can pass legislation authoriz- abuse problems through early intervention, efforts. The initiative is ing the courts to suspend or revoke the the work of a team of state government experts in health, public driver's license of persons convicted of safety, education, mental health and youth. committing a traffic violation while under the influence of alcohol and other drugs. Reinstatement or return of license should depend on the offender being screened for alcohol and/or drug problems and successfully completing treatment. Legislation might be considered to es- tablish the civil liability of individuals who negligently sell or serve alcoholic bev- erages to persons under the legal age, or those who are visibly intoxicated and, as a result, injure themselves or another. States also may evaluate the role of alco- holic beverage control authorities to en- sure that protection of public health and safety is their primary concern. PAGE 108 AGENDA FOR STATE ACTION Develop a centralized system to collect data about drug and alcohol problems in the state in order to determine target pop- ulation and what elements should be in any comprehensive strategy. Collect statistics on drug-related arrests, accidents, deaths, school dropouts, sus- pensions and expulsions. Insurance claims, hospital admissions, and worker compensation claims should be available to begin planning. Review current programs in the public and private sector to understand current prevention efforts and to determine what areas need help or attention. A ny state can win the war against drug and alcohol abuse with a serious com- Identify the impact of drug and alcohol mitment to a comprehensive plan and abuse on the private sector, schools, and strong leadership from its Governor. Any other areas, and determine potential sav- plan should include the elements of pre- ings of prevention programs. vention and education, training and pro- fessional development, intervention and Locate every agency of state government treatment, and interdiction and law en- that deals directly with drug and alcohol forcement. The plan must also be realistic abuse and review the ability. of each to and allow all groups to work together. carry out program responsibilities. Strong leadership and support from the Governor is a key to the success of any Report all findings to the Governor to Agenda for State Action. The Governor's begin effective programs. commitment to long-term solutions and concerted action on a variety of fronts is essential. But where can a state begin? How can a 2 state find a workable solution to the sub- stance abuse problem? Many programs Find a Program are already in place, but if more attention That Works needs to be focused there are some basic steps that can be taken to succeed in the Begin planning a comprehensive strat- war against drug and alcohol abuse. egy that includes the elements discussed in this report. Any strategy must focus on prevention and education as a way to get a handle on the abuse problem. Programs 1 must be developed for all age groups, and must involve students, parents, teachers, Lay the Ground Work business leaders, clergy, and law enforce- ment. Designate a clearinghouse for the infor- mation, such as a task force, that will re- port to the Governor on the nature of the problem and development of the strategy. PAGE 109 @ Youth Programs Reach Out Boy Scout Councils throughout Kentucky are "Saying No to Drugs" through their national program, Drugs: A Deadly Game. This educational program includes a video, Provide training and professional devel- Identify current expenditures for on- teacher's guide, and printed opment for those involved in the prob- going programs at the local, state, and materials that could reach lems of abuse. Training must sharpen the federal level. 86,000 scouts. These materials ability of teachers, judges, social workers, are also available to schools and others to spot problems early; ex- Explore new funding sources within and other organizations. plore the various causes of abuse; discuss state government for any new programs. appropriate treatment for different age The Northern Kentucky Division groups and varying causes of the problem. Seek support from the general assem- of the Cincinnati Community bly, businesses, and communities. Chest bas adopted "Project Enlist the media to assist in education Charlie," a substance abuse and prevention programs. prevention program for 4 elementary school children. The Identify those who need help through emphasis is on early education intervention and treatment. Social service Rally Support for the Plan and the development of positive agencies must be more agressive in iden- bebavior choices. tifying problems related to abuse; the Act as the key supporter for the compre- criminal justice system should try to iden- hensive prevention strategy. The Gover- In several Kentucky counties, tify those who require treatment; school nor should be a central figure for mobiliz- 4-H Councils are working with systems should also be aware of those ing community and state government the schools on drug abuse. who have abuse problems. cooperation. Franklin County has 1,500 participants in a "Be Smart, Involve law enforcement agencies. Ef- Encourage state agencies to work to- Don't Start" program for eight- forts to control the supply and demand of gether and cooperate in areas of preven- to twelve-year-olds. In Graves substance that are abused should be sup- tion and treatment in addressing the County, 400 children have ported. Laws relating to drunk driving, abuse problem. participated in their local 4-H sale of alcohol to minors, and illegal drug program. sales must be strictly carried out. Rally local communities to get involved statewide to carry out an effective strategy. Encourage the federal government to Boys Clubs of America's "DRUG continue cracking down on illegal drug Work with and find support in the busi- FREE and Proud to Be!" sales and smuggling. ness community by stressing what an program was adopted in abuse-free workplace can mean to Louisville, Ky., and more than Dedicate more resources to enforce- industry. 6,000 commitments have been ment procedures. obtained from youth who The Governor should convey the promise to stay drug free. Peer strong message that drug and alcohol pre- pressure to stay away from 3 vention can be accomplished. When state drugs is a key element. agencies, local communities, business Find Funding for the Plan and industry, and law enforcement come In Kentucky, the Buddy and together on a specific strategy for Teen Buddy program is an Determine funding needs and pri- development, the Governor can be the outgrowth of Boys Clubs of orities for the strategic prevention plan guiding force in reducing this barrier to America's "Youth Helping Youth" and consider funding sources. the nation's individual and collective program. This program targets productivity. inner-city youth. Building self- esteem and positive behavioral patterns are the main objectives. The program works with the local community mental health center. PAGE 110 STATE INITIATIVES M any states and Governors have al- ready realized the seriousness of substance abuse and its effects on the gen- NORTHICAROLINA eral population, and as a result they have The Governor's Council on Alcohol and Drug Abuse Among Children begun to implement programs and initia- and Youth was established to create a new awareness of the problem tives to deal with the problem. in the state. The council is charged with reviewing the problem and Several programs began with federal making recommendations to the Governor on youth substance abuse funds to support mental health and sub- issues. It assesses mechanisms for coordinating state and local stance abuse initiatives. However, numer- resources; conducts public hearings; promotes local boards, coun- ous states have taken the lead in dealing cils, or commissions to identify model prevention, intervention, and with the problem. treatment efforts for possible statewide replication; and conducts There are common characteristics that public awareness activities. run through many state programs which The Governor challenged every local community to form a local have already been discussed. The main task force or coalition on substance abuse. A statewide conference components of these programs are public will be held in the fall of 1987 for local officials, law enforcement awareness, education, and community in- personnel, business leaders, education officials, health organiza- volvement. In many cases, all segments of tions and civic leaders to come together to share information and the population are called upon to get in- build a solid foundation for addressing the drug problem. At the volved with the comprehensive plan. forum, a booklet on state resource programs will be released that The task force recently surveved the will contain information on every anti-drug effort at the state level. states for new programs in alcohol and drug abuse prevention. Governors were in the forefront of many of these efforts: MASSACHUSETTS only a few are highlighted in this report. The Governor's Alliance Against Drugs, created in December 1984, is A complete summary of all state programs a coordinated statewide effort to mobilize communities to implement can be found in the Supporting Works drug and alcohol abuse prevention programs with a goal of drug-free for this report. schools by 1990. The nationally acclaimed program, which began with eighteen communities and has grown to nearly 300, requires each community to form school-community advisory councils made up of education and political leaders, law enforcement agencies, and the business community. The councils help local school districts implement drug and alcohol prevention curriculums from kindergarten through twelfth grade; review and update school discipline codes; develop written agreements between school and police officials on proce- dures dealing with drug use and sale in and around schools; imple- ment peer and parent education programs: and provide access to community treatment resources for youngsters with substance abuse problems. PAGE 111 WORKS CONSULTED Blue Cross of Greater Philadelphia. 1981. National Criminal Justice Association and U.S. Department of Education. 1986. Joint Health Cost Containment Program the National Governors' Association. 1985. Schools Without Drugs. Washington. D.C.: Utilization Report. Philadelphia, Pa. State Laws and Procedures Affecting Drug U.S. Department of Education. Trafficking Control: A National Overview Bureau of Justice Statistics. January 1983. Washington, D.C.: National Criminal Jus- West, L.J. 1984. Alcoholism and Related Prisoners and Alcohol. Washington, D.C.: tice Association. Problems. Englewood Cliffs. N.J.: Prentice- U.S. Department of Justice. Hall. National Institute on Alcohol Abuse and Bureau of Justice Statistics. March 1983. Alcoholism. 1981. Fourth Special Report to Prisoners and Drugs. Washington, D.C.: the U.S. Congress on Alcohol and Health. U.S. Department of Justice. Rockville, Md.: Alcohol, Drug Abuse and Mental Health Administration. Carroll, J.M. 1985. The Commonwealth at Risk: A Report by the Governor's Task Force National Institute on Alcohol Abuse and on Drug and Alcohol Abuse Prevention. Alcoholism. 1983. National Drug and Al- Frankfort, Kentucky. cobolism Treatment Utilization Survey, Comprehensive Report. Rockville, Md.: U.S. CBS News Poll. 1986. Drugs In America. Alcohol, Drug Abuse, and Mental Health New York. Administration. Cook, P.J. 1984. "The Economics of Alcohol National Institute on Drug Abuse. 1983. Consumption and Abuse." Alcobolism Alcohol and Health. Rockville, Md.: U.S. and Related Problems. 56-77. Englewood Alcohol, Drug Abuse, and Mental Health Cliffs, N.J.: Prentice-Hall. Administration. de Bernardo, M.A. 1987. Drug Abuse In the National Institute on Drug Abuse. 1984. Workplace: An Employer's Guide for Pre- Use of Licit and Illicit Drugs by America's vention. Washington, D.C.: U.S. Chamber High School Students 1975-1984. Wash- of Commerce. ington, D.C. Fein, R. 1984. Alcohol in America: The National Institute on Drug Abuse. 1985. Price We Pay! Newport Beach, Calif: Care Drug Use Among American High School Institute. Students, College Students, and Other Young Adults. Rockville, Md.: U.S. Alcohol, Gallup Poll. 1985. Cited in The Common- Drug Abuse and Mental Health Adminis- wealth at Risk: A Report by the Governor's tration. Task Force on Drug and Alcohol Abuse Prevention. Frankfort, Kentucky. National Institute on Drug Abuse. 1987. Technical Review Meeting on Needle Shar- Graham, Robert. 1985. Testimony on Drug ing Among Intravenous Drug Abusers: Na- Trafficking and Border Interdiction. Wash- tional and International Perspectives. ington, D.C.: U.S. Congress. House Judici- Rockville, Md.: U.S. Alcohol, Drug Abuse ary Committee. Subcommittee on Crime. and Mental Health Administration. National Association of State Alcohol and National PTA Bulletin. 1986. Drug and Al- Drug Abuse Directors. 1984. Alcohol and cohol Awareness Week. Chicago, Ill.: Par- Drug Problem Costs, Programs and Ser- ent Teacher Association. vices. Washington, D.C.: National Associa- tion of State Alcohol and Drug Abuse Directors. PAGE 112 THE STATE PRODUCTIVE PEOPLE PRODUCTIVE POLICIES NATIONAL GOVERNORS' ASSOCIATION Task Force on Alcohol and Drug Abuse Chairman Martha Layne Collins Governor of Kentucky TASK FORCE MEMBERS Steve Cowper Governor of Alaska Evan Mecham Governor of Arizona Terry E. Branstad Governor of Iowa James J. Blanchard Governor of Michigan Ted Schwinden Governor of Montana James G. Martin Governor of North Carolina Rafael Hernandez-Colon Governor of Puerto Rico Edward D. DiPrete Governor of Rhode Island Ned Ray McWherter Governor of Tennessee William P. Clements Jr. Governor of Texas Tommy Thompson Governor of Wisconsin National Governors' Association The National Governors' Association, founded in 1908, represents the Governors of the fifty states, the Commonwealths of Puerto Rico and the Northern Mariana Islands, and the territories of the Virgin Islands, Guam, and American Samoa. Its mission is to influence the development and implementation of national policy and to apply creative leadership to state problems. NGA membership is organized into seven standing committees in major substantive areas: Agriculture, Criminal Justice and Public Protection, Economic Development and Technological Innovation, Energy and Environment, Human Resources, International Trade and Foreign Relations, and Transportation, Commerce, and Communications. Special committees and task forces are formed in response to principal concerns of the Governors. The Center for Policy Research serves as a vehicle for sharing knowledge of innovative programs among the states and provides technical assistance to Governors. The center manages a variety of federal grants and foundation-funded activities and state demonstration programs in areas that include education, economic development, labor market and occupation analysis, socioeconomic forecasting, health care financing alternatives, job training, and state human resources management systems. Office and Committee Staff Directors Raymond C. Scheppach, Executive Director Charles M. Cochran, Administration and Finance Rae Young Bond, Public Affairs Joan L. Wills, Research and Development James L. Martin, State-Federal Relations Barry Van Lare, State Services Barbara L. Fontana, Agriculture Nolan E. Jones, Criminal Justice and Public Protection Richard B. Geltman, Economic Development and Technological Innovation Thomas W. Curtis, Energy and Environment Alicia C. Smith, Human Resources Deirdre E. Curley, International Trade and Foreign Relations Charilyn W. Cowan, Transportation, Commerce, and Communications Cover Design by Marty Anderson, Design Group, Washington, D.C. Copyright 1987 by the National Governors' Association. National Governors' Association Hall of the States 444 North Capitol Street, Suite 250 Washington, D.C. 20001-1572 (202) 624-5300 TABLE OF CONTENTS Acknowledgements 1 PART ONE: The Task Force 3 PART TWO: Alcohol and Drug Abuse Prevention: From 25 Knowledge to Action PART THREE: Alcohol and Drug Abuse Prevention Programs in the 53 States PART FOUR: Additional Resources 77 ACKNOWLEDGEMENTS There are many individuals and organizations who contributed to the development of these supporting works for the Task Force on Alcohol and Drug Abuse Prevention. Substantive ideas were gathered from groups and individuals whose works are not included in the report, but whose suggestions are apparent. First, Gwen Holden and the staff of the National Criminal Justice Association served as a valuable resource and a source of constant inspiration during the development and production of this report. They helped in editing, suggesting resource groups, and staging the Task Force Hearing in Lexington, Kentucky. Second, The Office of Substance Abuse Prevention (OSAP) was very helpful throughout this project. Carl Hampton of that office assisted in getting witnesses for the Task Force Hearing in Kentucky, and the National Governors' Association's winter meeting. Dr. Donnie Hassler of OSAP has been a great help in seeing that the expert paper on "From Knowledge to Action," which is in this report, was developed. She worked with the staff in putting together an outline and a final report that offers advice on dealing with substance abuse prevention. The project staff is overall indebted to Dr. Reed Bell and the OSAP staff. Finally, the Kentucky staff of Mike Townsend and Barbara Stewart were of great assistance to the Task Force. They not only assisted in preparing the report, but they developed the Task Force Hearing in Lexington, Kentucky, and secured witnesses for the NGA winter meeting on the "Barriers Project." The staff will be forever grateful to them. Special thanks is owed to the following organizations and individuals who help provide intellectual support for the ideas in these supporting works: Richard J. Klemp and John E. Shafer, Jr. from the Miller Brewing Company; Kawala Brush of the Children of Alcoholics Foundation; Bill Forman of General Electric Company; Fran Hurtado of Mothers Against Drunk Driving (MADD); Dr. William Butynski of the National Association of State Alcohol and Drug Abuse Directors (NASADAD); Dr. Jean Kirkpatrick of Women for Sobriety; Dr. Bill Braden of the Kentucky Association for Counseling and Development; Barry Bertram of the Kentucky Commonwealth Attorneys Association; Alex Brodrick of Volunteers of America; The American Public Health Association; and Dr. George R. Ross of Possiblities Unlimited in Lexington, Kentucky. Of course, in trying to think of the numerous people who helped us in the project, someone's name will not be mentioned due to oversight. For this, we apologize. 1 PART ONE: The Task Force 3 TASK FORCE ON ALCOHOL AND DRUG ABUSE Public Hearing January 28, 1987, Lexington, Kentucky Introduction Kentucky Gov. Martha Layne Collins, chair of the Task Force on Alcohol and Drug Abuse, convened a national public hearing in Lexington, Kentucky, on January 28, 1987. Joining Gov. Collins were representatives of other Governors on the task force, including Dr. Robert Brock, Michigan; Dr. Richard Freeman, Rhode Island; Bruce Marshburn, North Carolina; and Thomas F. Miriello, North Carolina. Several Kentucky agency officials also participated, including Al Austin, secretary of the Cabinet for Human Resources; Dennis Boyd, commissioner of the Department of Mental Health and Mental Retardation Services; and Norma C. Miller, secretary of the Justice Cabinet. At the hearing, the task force sought the advice and counsel of substance abuse experts with a view toward hearing their recommendations for education and prevention, early intervention and treatment, and law enforcement strategies that states can use to address alcohol and drug abuse. This summary presents major recommendations from excerpts of testimony provided at the hearing; and written statements submitted for the task force's consideration subsequent to the hearing. Dr. Reed Bell, Director, Office of Substance Abuse Prevention, U.S. Department of Health and Human Services The federal government responded to the problem of community drug abuse with congressional passage of the Anti-Drug Abuse Act of 1986. President Ronald Reagan signed this act into law on October 27, 1986. The act created the Office of Substance Abuse Prevention as part of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) to complement the National Institute of Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Drug Abuse (NIDA), and the National Institute of Mental Health. All of these agencies are within the U.S. Department of Health and Human Services. OSAP is located organizationally within the office of the administrator of ADAMHA and is interrelated through that office with the treatment and prevention research that has gone on for years in the other institutes which provide an excellent resource for OSAP. OSAP uses this base of information to improve its efforts to prevent drug abuse. 5 After the law was signed the office held a National Strategy Conference. This is one of the first times that the federal government has elected to invite the "grass roots" to come and help formulate appropriate strategy nationally with an eye toward making prevention not only a new trial but a new success. About 200 people attended the conference in Washington on December 15-16, 1986. Different areas of substance abuse and prevention were addressed. This discussion led to the structure of the office. The Office of the Director supervises four division operations: Information Services, Community Assistance, Demonstration Programs, and Evaluation and Research. Information Services. This division sorts out and integrates the acaringhouse activities of NIAAA, NIDA, and other related substance abuse programs. It provides an effective source of information on substance abuse through data bases and a telephone service. The division also includes a publications unit that reviews all publications, improves them, and tries to make them available to communities. In addition, the unit handles media and public affairs, which includes an effort to use media personalities and entertainers to promote substance abuse prevention efforts nationally. Community Assistance. This division will facilitate work being done at the community level. The division will focus on four groups: parents, youth, schools, and minority groups. Active parents at the community level are a key factor in determining the effectiveness of prevention programs. Youth are the second priority, based on the impact they can have on community substance abuse prevention efforts. There is excitement about youth - their idealism, their openness - and about mobilizing them in prevention efforts. They are willing to listen to anti-drug messages. The third priority area is the schools. OSAP is working actively with the Department of Education to make its research base available throughout the education system. The fourth area will focus on minority groups, especially high-risk populations. An ombudsman for minority interests and groups will serve within the office of the director. Demonstration Programs. This division was mandated under the law and will be a $24.5 million program aimed at identifiable, high-risk groups. There will be three grants under this effort: one targeted to comprehensive systems within the community; a second targeted to at-risk populations; and a third targeted at prevention and early intervention. The division is looking for community-based programs with demonstrated effectiveness in prevention and intervention techniques to use as models in other communities. Much of this division's work will be devoted toward evaluation and research of those particular efforts to discover what seems to work and what can be done better. Evaluation and Research. This division will focus on the findings of prevention research carried out by the institutes. This information must be available to the agency and then made available to communities so that the problems of prevention can be addressed more effectively. The Office of Substance Abuse Prevention has $42 million for recognizing not only what works in prevention, but to serve as a facilitator in helping those at the community level. Of course, $42 million is not enough to carry out national prevention programs. The organization, though, is structured to assist states and communities that are addressing these problems. In a real sense, OSAP is a special office, of prevention, and to address this issue it will work with states and communities in every way in terms of information resources; in terms of information resources; in terms of community assistance; to schools, to parent groups, to youth groups, to minorities, and to special interests; and in terms of research and evaluation. The operative philosophical blueprint for developing prevention strategies divides the substance-abusing populations into categories of "easy" and "hard" and the "older" and "young" These divisions are reflected in the schema below. 6 Easy Hard Young Just Say No High Risk Youth Old Workplace Chronic Addiction (20-40 years of age) The workplace-effort, focused roughly on persons 20 years to 40 years of age, has been assigned to the National Institute of Drug Abuse. This agency is working on the implementation of a drug- free workplace initiative. Prevention efforts will focus on normative values in the workplace -- alcohol and drug abuse shouldn't be tolerated, particularly where they create safety problems, performance problems, and, of course, health problems. For some of the young group, there is the "Just Say No" effort. It is readily apparent that for a large percentage of the young people, this is the right message. Then there is a segment of high-risk youth who are considered difficult to serve. A "Just Say No" message cannot simply be offered to this population. More active interventions are needed. Finally, there is the older, hard-core narcotics population that has very serious substance abuse problems. Efforts directed at these individuals also are being addressed by the National Institute for Drug Abuse. Dr. Merita Thompson, Department of Health Education, Eastern Kentucky University Within the context of substance abuse prevention programming in schools, it is important to recognize that we must look at schools with an eye to their relationship with the rest of society. Schools have a key role to play, but they often have been given too much blame for the problem and too much responsibility for the solution. When you consider the possible impact of all the other influences on a child's life, we cannot be surprised when classroom programs often do not show immediate and drastic results. All of us will have an impact on the life of a child, and school has a role to play, but it is a part of a larger picture. By now, most major newspapers in the country have carried articles on the fact that we have few drug prevention programs or schools that are proven to work. In reality, when one examines the hundreds of studies that have been conducted to determine the effect of various programs and approaches, most of the programs or evaluations are so flawed in design or implementation that the safest statement we probably can make is that we have a lot to learn about what is best and what works well, and drug education truly is in its infancy. Substance abuse prevention programs, including those in schools, can fail in a number of ways, and it is important to look at those as we consider what we understand about prevention programming for schools -- first in concept, then in operations, then in implementation, and finally in evaluation. Any program that is conceptualized without thought given to distinct populations and their different needs and receptivity will be destined to have results that, at worst, fail, and at best, are skewed or distorted. We must learn to plan for the different populations in any classroom in order to expect the results that we are hoping for. When programs are based on the theory that knowledge equals attitudes equals behavior, they may err in many ways. We don't always know what knowledge results in what attitudes, or what attitudes result in what behaviors. In operationalization, knowledge selected in a program is very critical. It must be sufficient to make people perceive they are at risk. For example, some curriculum guides spend time discussing 7 how beer is made, although that information probably doesn't help people make decisions about their own choices regarding alcohol consumption. In implementation. time is of critical importance. We know from research and experience that programs that are more intense, that are longer in duration, tend to have better results. Yet, we have programs that are very short, that are spattered and spotted, and would have no logical sequence. The sequence of experience is very important. The readiness of a child at different levels is a critical issue in choosing information and activities that will make that child perceive himself or herself to be at risk. Inadequate teacher training in affective areas can lead to disastrous results. In evaluation, possible errors are too numerous to mention: there are problems with cross- sectional versus longitudinal design; variables that are not controlled; evaluation instruments that do not reflect content; and, particularly, behavior related to substance abuse that is not being evaluated. One of the more important conceptual errors that also is an evaluation error is that other influences may play a much more powerful role than what we are doing in the schools. Major reviews of hundreds of studies have been conducted, and most studies have been found to be flawed in one or more of these four areas, in such a way that logical, valid conclusions cannot be drawn from them. Is the logical choice then to throw up our hands and in frustration and cynicism, say drug education does not work, and do nothing? No, we can't just wait until we understand the phenomenon to do something about it. We have to take our best shots now. We can proceed based on, at least, observation and experience, research into the etiology and correlates of drug abuse, and findings on what has worked in acceptable research that we do have. We can proceed and we must proceed in the schools. The importance of beginning any effort with a plan for evaluation cannot be overstated. To look, then, at what schools can and should do in the area of substance abuse prevention, these goals should be addressed: to delay the onset of use of substances; to provide information and skills that will enable students to make low- risk, healthy decisions now and later in life; and to provide a process for effective intervention with high-risk, drug-abusing students. Schools also should contribute to the development of a healthy self-image that is sufficiently positive to enable a student to apply the information skills he gains in school. Schools can't take full responsibility in that, but they have a contribution to make and a role to play. Needless to say, these latter goals are appropriate also for faculty and staff at schools. Our best shots in realizing these goals based on what we understand at this point in history, and knowing that we are in infancy in research and understanding in many ways, are these: First, there must be a planning process in schools that includes a team of people made up of school personnel and representatives from community leaders, parents, and substance abuse professionals. Second, the planning team, the superintendent, and the school boards should take a global view of prevention programs for schools. Curriculum and classroom instruction are important. But so, too, are policies that are fair, consistent, and well-understood by students, personnel, and parents, and that support the goals of prevention and intervention. 8 Third, a good prevention program also will provide for education for all teachers and others in the school who have an impact on youth. Over time, in-service programs can reach all school personnel if the commitment is there. The school can conduct or actively support drug-free alternatives for young people, including recreational alternatives. Fourth, perhaps no component will be more important than parent education. Of the correlates of drug abuse, most of them involve the parent. If there are social correlates, most of them relate to the parent .. parent involvement, parental drug abuse, parental expectations, etc. Every school has a population. that is at high risk for drug abuse, and schools need intervention plans. Some student assistance programs have been found to be very effective with the high-risk population -- kids who are children of alcoholics, low-achieving youngsters, kids who don't fit in, and others. In addition, any good curriculum will result in identification of young people who are abusing drugs in high-risk ways and need help and intervention. It's not enough to react only punitively to their behaviors. Through personnel planning, comprehensive discussion and planning of a process, and networking with parents and community resources, any school in the nation can provide some degree of help and intervention to these high- risk young people. To truly evaluate a school prevention program is one of the most important needs. A data base must be established and monitored continually for changes. And this needs to be done at the state level and the community level. The ultimate criterion is behavior. We will never really know about the efficacy of our school programs until we monitor drug-related behaviors. But interpretation of such data must always be tempered in reference to the school, with a realistic look at other influences on student choices, and especially the prevailing attitudes and behaviors in the adult community. The backdrops of a sound academic program and positive school climate are very important. A sound, success-oriented academic program, in fact, may be the single most important component of a substance abuse prevention program. Kids who achieve in school, expect to do well in school, and have academic goals have significantly lower rates of substance abuse. A positive climate in which a child feels valued and free to create and explore his or her own decisions is absolutely essential. Curriculum is what most people think of when they think about prevention programs in schools -- sequential, integrated, well-planned to be appropriate at appropriate times and in appropriate ways. One avenue of drug education is drug information. Factual information often has been used alone as the sole prevention effort. It often has been presented with a backdrop of moralizing or scare tactics. It often has been selected and presented with no thought given to the target subgroups in a classroom. And it often has been selected with no thought of its relative relationship to behavior. Information is not the baby to be thrown out with the bath water. People need factual information to help them perceive the risks and to understand their alternatives. It can have a cumulative effect over time, and we haven't measured that well. Building self-esteem has not been researched very well in relationship to specific drug-using behaviors. But building self-esteem has been shown in many studies to evidence a decrease in absenteeism, delinquency, and other cluster behaviors that are correlates of drug abuse. Time, good planning, future training, and commitment can make this a valuable contribution to a school program. Skill building in these areas has a new promise on the horizon, and the studies are encouraging. The relationship among some of these efforts, especially assertiveness skills, peer refusal skills, and decreasing smoking and decreasing alcohol use and marijuana use, especially at some grade levels, is very heartening. We need to continue to monitor that, to continue to explore, to continue to evaluate, for these other areas can also make a contribution to the school program in 9 valuable ways. Kids who have a direction tend to use substances less often, and thus career education and self-improvement areas potentially can be important. Decision making has a large base of support in health education literature. We don't know exactly the best techniques to bring the best results in terms of teaching decision-making skills. But it is essential that we move into that area. People do need decision-making skills. They need problem-solving skills, and we can find the ways and evaluate the ways to best teach them. Our best educa! onal approach is to incorporate as many of these as we can and not jump on the bandwagon of one and exclude the others. Major points to keep in mind include: Information about drugs is probably best done in combination with skill building in these areas and self-esteem building, especially at the lower grades. Students must have sound information to help them perceive their risks if they are to choose wisely over time. However, information often is not enough by itself, and decision-making and peer relationship skills are needed. A positive self-image will help them apply what they learn and enact the decisions they choose. We need to teach all of these, while continuously evaluating what we are doing and monitoring the research as it is being reported. Schools may purchase a program or choose to build their own curriculum, and there is value in both. It is very important that the team planning be a part of that. Colleges and universities need to provide information and skills for their general student body much as the public school does. We are finding some interesting things about what they don't do in that area. From all indications, substance abuse information for the general college population is at best three to four hours in a health class, and, commonly, it is nothing at all. Evaluation is lacking. It is needed in behavioral terms on college campuses, and it goes sadly lacking on most. As with the local schools, colleges and universities need to establish a data base that could be used for decision making and for evaluation; an intervention plan that ideally would include a student assistance program; and a drug awareness program, not only for staff but for faculty, also. It would be very helpful for a campus to have inservice programs for faculty and other personnel. There is a surprising amount of ignorance among these individuals regarding substance abuse among their students. And student housing staff probably do it best, but there is a great need there. Sadly, colleges and universities play a key role in another area, but don't often meet that very well. They are charged with preparing professionals, especially in human service areas that require a sound background in substance abuse. Most schools have never conducted a campus study of the adequacy of substance abuse education for these professionals. Institutions of higher learning need to assume more of a role in alcohol and drug abuse prevention research. That is within their role and certainly the need is there. James Neal, Director of Prevention Services, South Carolina Commission on Alcohol and Drug Abuse Each state has a designated lead agency for alcohol and/or drug abuse that is a member of the National Association of State Alcohol and Drug Abuse Directors (NASADAD). Collectively, this group contributes to major governmental efforts to prevent and treat the problems resulting from the abuse of alcohol and other drugs. NASADAD has recently recommended a strategy to reduce the demand for alcohol and other drugs. It is a multifaceted strategy that calls for: 10 greater access to drug and alcohol treatment services; a major commitment to comprehensive drug and alcohol prevention education programs in our schools and in our communities; greater public awareness and education that treatment and prevention programs are available; more utilization of the well-established state networks for treatment and prevention programs; and expansion of private and public third-party reimbursement for treatment services to encourage greater participation by the private sector. Treatment is included as part of a prevention or demand reduction strategy. This is because NASADAD, as well as many of its individual members, uses a public health concept of prevention. This concept recognizes a continuum of services, and not sharp distinctions between primary prevention, intervention, and treatment. Treatment, hence, is a vital part of prevention because of this concept, and also because of the population of users that consumes most of the alcohol and other drugs. For example, we know that there is a direct relationship between the amount of alcohol available in society, the amount consumed by the population, and the incidence of alcohol- related problems. Since about 20 percent of the alcohol-using population consumes almost 80 percent of the alcohol in this country, and this population presents the major concerns for treatment, we also reduce the demand for the drug by treating these individuals and by having early intervention programs. The National Prevention Network (NPN) is an arm of NASADAD made up of the designated state prevention coordinators from each state and territory. NPN recently addressed letters to the Alcohol and Drug Abuse Mental Health Administration, the U.S. Department of Education, and the U.S. Department of Justice calling for the development of a national prevention strategy that would include several elements. First, the letter calls for a five-year prevention plan. It appears that our response to the problems resulting from the use and abuse of alcohol and other drugs moves from year to year, from drug to drug, and from population to population. That is not the way to do good prevention planning. It is not the way to measure our results. So, it is essential for good long- range planning in prevention to take place that recognizes that the drug scene does change, but that there are some components that take time to put into place and to measure. Second, this letter calls for the creation of a comprehensive system for prevention in schools and communities, with emphasis on communities. We seem to have a tendency to want to focus all our prevention efforts on adolescents within the schools because they are the easiest population for us to target. We tend to forget that there are other communities that exist around schools. We also tend to forget that we have about a 26 percent dropout rate in this country, so many adolescents who are at the highest risk for abusing alcohol and other drugs are not in schools. Hence, we need to recognize that we don't need an approach to the prevention of abuse of alcohol and other drugs that focuses solely on the school population. We need a community approach that recognizes school dropouts and other high-risk groups within the community, such as the elderly. Other components the approach calls for include: A consistent review of the funding process between the federal and state governments because we tend to operate in isolation with different parts at each level of government going their own way. Use of existing networks because there are now many networks that are in possession of a great deal of information and experience and are very willing to work in this area. 11 A balanced approach between alcohol and other drugs. The most recent efforts on the part of the federal government have once again tended to focus on the so-called illicit drugs. While these are certainly major concerns, we need to recognize that in this country our number one drug of abuse has always been and still is alcohol. Hence, we need to have a balanced prevention approach that addresses alcohol as well as other drugs. A commitment to increased intervention and treatment services. The adoption of a continuum of care con rept. The creation of advisory bodies. We particularly recommend that states create a state-level supply/demand reduction task force that would be composed of representatives from agencies that are concerned about the supply of alcohol and other drugs and how such substances get into society; representatives from health and human service agencies that are involved in reducing substance demand; and representatives from citizen groups that are actively involved in this field. Comprehensive training and technical assistance programs. A heightening of public awareness of the greater availability of effective prevention and treatment approaches. The objectives of alcohol and drug abuse education and prevention initiatives are to: develop critical thinking skills and self-competency skills; provide specific information about alcohol and other drugs; instill information about healthy lifestyles; increase self-awareness; build self-esteem; impart interpersonal relationship skills; inform the advertising community about alcohol and drug abuse and help this community recognize the influence they have on personal decisions regarding use; communicate information about the supply of alcohol and other drugs and the impact that this has on other public policies; promote public policies that support healthy lifestyles; and promote peer resistance skills. The human body doesn't make any distinctions as to whether or not it has ingested an illicit drug or a legal drug. Therefore, in some ways our prevention efforts need to clearly state that a drug is a drug. However, in other ways, some distinctions must be made because our society recognizes alcohol is frequently treated differently from other drugs. We also tend to treat nicotine and caffeine differently from other drugs. We need to recognize these attitudinal and public policy distinctions when we are planning prevention programs. The South Carolina Commission on Alcohol and Drug Abuse is an independent state agency governed by a board appointed by the Governor and confirmed by the Senate. This commission 12 recently adopted an Alcohol Policy Bill of Rights, which addresses many of the distinctions in preventing the problems resulting from the use of our legal drug - alcohol. The Alcohol Policy Bill of Rights is based upon four principles: that abstinence is always an acceptable choice; that alcohol consumption considered to be high risk is actively discouraged; that alcohol consumption considered to be low risk is acceptable; and that heavy alcohol consumption is discouraged in all situations. Now, based upon those four principles, there are some six rights within the Alcohol Policy Bill of Rights: The right to warning and beverage ingredient labeling so that consumers know the potential health risks of alcohol consumption; prominent displays of information; and elimination of misleading alcohol advertising or equal time for public health counter-advertising. The right to safe communities and roadways, including certain and swift enforcement of driving while under the influence laws; mandated server intervention programs and liability information; local and state alcohol beverage regulations that would control the number, location, and types of alcoholic beverage outlets; adequate funding of alcoholic beverage control commissions; and insurance incentives for safe and sober driving. The right to health-enhancing alcohol pricing, which uses adequate tax increases to discourage high-risk alcohol consumption, and equalized tax rates for all forms of alcoholic beverages; The right to protect our youth by having adequate funding for alcohol prevention education programs; adequate enforcement of the minimum purchase age law; and an end to alcohol consumption promotions aimed at youth, particularly those promotional activities on colleges and university campuses; The right to safe workplaces, to put an end to the pressure to use alcohol as a part of conducting business and the federal tax subsidies for corporate alcohol use, adequate funding of employee assistance programs, and an end to government subsidies for alcohol within the Armed Forces. The right to health services, the right to effective, low-cost recovery services available to the entire public, and assistance programs that would look at financial reimbursement and emotional and medical support for the victims of alcohol-related incidents. The components of an effective alcohol and drug education prevention strategy should be under a public health concept that recognizes primary, secondary, and tertiary prevention, but also recognizes the agent, the host, and the environment, and the interrelationship among those three. We tend to focus most of our efforts toward the host by providing information and self-esteem building, self-awareness, self-competency, coping skill and decision-making skills, and ignore the environment in which those decisions take place. Hence, I think developing peer resistance skills or social resistance skills, or what some people call inoculation skills, becomes a very, very important part of host approaches to prevention. But, until we begin to look at policy issues that influence the environment, the supply of alcohol and other drugs, and how people make decisions when they relate to their environment about the use of alcohol and other drugs, then we have not really developed a comprehensive strategy. 13 A tremendous amount of research has been done on effective prevention approaches to the abuse of alcohol and other drugs, and new prevention strategies are always being discovered. We know a lot about what works, and perhaps even more about what does not work in alcohol and other drug abuse prevention. Certainly, prevention programs that have been directed toward the schools provide 3 great deal of information. We know, for example, that the approach that grew out of the Harry Anslinger era of the thirties and forties, and moved onto the fifties and sixties, of trying to approach the problem by providing information, and particularly information that had sort of a moral slant to it, does not work. We know that information alone does not, in itself, change behavior. Information, though, is the basis for changing behavior and hence is a very critical part of any approach to primary prevention. In alcohol and other drug prevention fields, we seem to have moved, particularly in the schools, to trying to combine information with effective education approaches. The idea, here, is that if we give young people information about a drug and then combine that information with some experiences around decision making, then the student will make the right decision. The prevention research has not shown that always to be true. This research is not in and of itself an indictment of affective education approaches. It is more of an indictment about our state-of-the-art in prevention and attempts to evaluate something as complex as human behavior and decision making. There is another ingredient that is now appearing in substance abuse prevention strategies, that started with smoking cessation programs but is now being applied to alcohol and other drugs. This is delaying or preventing the onset of use through the development of peer resistance skills. The "Just Say No" movement is part of that concept of saying no to drugs - "Be Smart, Don't Start, Just Say No." The research on peer resistance skills stresses the importance of being able to rehearse situations in our minds or with other people so that when we are confronted with the situation, we are more likely to say no. Hence, peer resistance skills are now part of the state-of-the-art knowledge about alcohol and other drug abuse prevention. There is a step, though, that has to occur beyond just saying no. Individuals need to know why they want to say no and be able to articulate these values that support the decision. It is not enough to be able to say no to drugs because that may not last. Part of the state-of-the-art in alcohol and other drug abuse prevention has to be related to the health promotion/public health movement. More and more we are beginning to address our lifestyles and look at things like smoking, eating habits, and dealing with stress. What is the appropriate government role in this field? The easy answer, of course, is to say that the appropriate role of government is to provide more funds and more resources. There is, however, much more that government can do. It is also a question of leadership and policy development. Specifically, government has a responsibility to be a leader in examining public policy and the promotion of supply/demand reduction. We need, for example, as part of our examination of public policy to review the role of ABC commissions in this country; are such commissions oriented toward protecting the public's health and safety, as was their original mission, or are they simply serving as tax-collecting arms of state government? Government also can have greater influence on universities and colleges, particularly the state- funded institutions. We must look at ways to get state-funded institutions to incorporate training on alcohol and drug abuse into their professional degrees. We do a terrible job in that area. It is a shame that every state-supported institution doesn't offer a course on alcohol and drugs for students, but, more importantly, offer training for people who are going into the professions. So, too, it is important for state government to establish supply/demand reduction task forces. For too long in our field, the people who have been involved with supply and interdiction have sat 14 on one side of the room, and the people who have been involved with demand reduction have sat on the other side of the room. We need to move away from this artificial distinction. The problems of alcohol and other drugs is one that needs the combined efforts of persons who are concerned with reducing the supply, as well as persons who are concerned with reducing the demand. These persons need to work together. All populations are in need of information. Our health education efforts should not discriminate yet, we need to recognize that there are some parts of our population, such as children of alcoholics, that are at higher risk than others in terms of the abuse of alcohol and other drugs. Schools can address this through student assistance programs that incorporate the identification of high-risk populations into their goals. Every high school should have a student assistance program that provides the administration with an alternative to the traditional sanctions that are imposed when a student is caught in possession of or under the influence of alcohol and other drugs. Student assistance programs allow for the student to be referred to a program that provides an assessment and appropriate education or treatment services. Every school also should have an employee assistance program to go along with a student assistance program, because while students have problems with alcohol and drugs, so do faculty and staff. There is a need, then, to recognize subpopulations, such as children of alcoholics, the elderly, and populations that may be more prone to use and abuse of over-the-counter drugs. These subpopulations need to be taken into account when designing programs. Dr. Beny J. Primm, Executive Director, Addiction Research and Treatment Corporation, Brooklyn, New York An article in USA Today indicated that alcohol and drug abuse ranked number two for mental health admissions in this country. This reflects how important this particular field is. What influences alcohol and drug abuse admissions is unemployment. When unemployment is high, alcohol and drug admissions to mental health institutions are great. When salaries are low, when there is a period of recession, admissions to alcohol and drug abuse mental health facilities are greater. So, it is tied in with economics and even sociological factors. Another factor all over our country is closing wards and mental health institutions. In New York State alone in 1987, there will be 7,000 people from mental health institutions who will be let out on the street. A number of them become homeless: there are no places for them to go, and many certainly fall or succumb to the problem of substance abuse on the street. Currently, only 100,000 people are in mental health institutions, and this year the number will be reduced to far less than that. Stress, too, is related to substance abuse. We have stress every day when we wake up, if we're cold, if we're hungry, if we have problems with our work or unemployment, or too little of this or too little of that. Most of us know how to cope with that stress. But many of us are never taught how to cope with stress. And as a consequence, we end up falling prey to, of course, substance abuse. One would think that stress is the lead reason for counseling, but it ends up being substance abuse. This is another reason why states must do something about the treatment of substance abuse. It is readily apparent how alcohol contributes to the poor health of all of our citizens. In New York City, it is the fifth leading cause of death of everyone. In my community (black), it is the second leading cause of death. The first leading cause of death is AIDS. The third leading cause of death in my community is homicide. The fourth leading cause of death is drug dependence. The use of crack is a serious problem in some communities such as New York. But if it's in New York, it's going to be in your state sooner or later. It's just a matter of time. We are now seeing kids buying crack at 10, 11, and 12 years of age. They smoke it on marijuana cigarettes or smoke it on other cigarettes. Crack is a smokeable form of cocaine that gets to the brain in eight to ten seconds, or less. The high is intense and rapid. It lasts three to five minutes, which means people end up having to buy drugs very frequently. The crash is very intense so they need a 15 parachute drug to come down; they will likely take something like cognac or a heavy-bodied liquor or one of the sedative hypnotic drugs to ease that crash. There is an intense craving secondary to taking this drug and a rapid addiction, with severe medical and psychiatric problems resulting. There is a treatment for cocaine-related problems, although there is no specific treatment for crack. One thing to do is to take people away from the availability of the substance. There are some chemotherapeutics that are being touted now as being helpful in the problem. But, if you introduce someone to another type of drug, you can cause another kind of addictive behavior. For cocaine treatment, one needs a short-term therapeutic community with ongoing, long-term follow-up with these individuals. Some of the common personality factors associated with addicts include problems of self-esteem and conflicting parental values. As an aside, if you have a mother or father who is an alcoholic, or you are male whose father is an alcoholic, you have a 50 to 75 percent chance of becoming an alcoholic. This would suggest that people who have a parental background of alcoholism should stay away from alcohol altogether. There are three different kinds of drug users. Experimental users may try various drugs once or twice out of curiosity and then leave them alone and go on about their business. A study of high school seniors in this country has shown that marijuana use really peaks at age 18. The study, though, had a great many weaknesses, especially since it did not adequately address drug use among dropouts. The states have to insist that the National Institute of Drug Abuse, which funds such studies, begin to look at dropouts because they have a 67 percent greater chance of being involved in substances than their cohort group of seniors in high school. Another kind of user is the recreational drug user. This is where drugs are taken to get high with friends at a party, and that is generally where things really start. These persons get used to a crack high, they long for it, and they can't do without it. The third kind is the regular drug user and the dependent user. They go on from the use of gateway drugs - liquor, cigarettes, and marijuana are considered gateway drugs -- to harder, more addictive drugs. There are a number of phases of drug abuse. In the first phase, the gains outweigh the losses. It is very difficult to get people into treatment when they are in this phase of drug abuse. The second phase is where gains and losses are equal. We sometimes get people into treatment from this phase who are generally forced into treatment by families or the court if they have a problem with the law and are sentenced to a drug treatment program. But in the third phase, we get a lot of people where the losses clearly outweigh the gains of taking drugs for many years. What we need in this country and in every state is a social model of prevention. The community needs to establish rules regarding chemical use -- when you can use these drugs; where you can use them; when it is legitimate to use them; is it necessary to use them; what behavior should be tolerated by individuals who do use chemicals; what behavior should not be tolerated? We also need to establish a way to communicate these particular "rules" to the rest of the community so they will know not to violate them, through the media, through schools, through churches, through the family. If we are going to be effective in trying to have a drug-free America, we first are going to have to not glamorize or advertise the use of alcohol and certainly cigarettes. As an aside, the leading cancer now among black women in this country is lung cancer. It now surpasses both uterine and breast cancer as the leading cause of death. Has the community established a system of accountability? In other words, through care, love, and concern, through family, friends, employers, schools, and the courts, have we decided what's okay in terms of behavior, in terms of chemical use, and decided what's not okay? And if somebody gets in the "what's not okay" area, have we decided to get them back into the what's okay area so that they can function in society and become taxpayers? It's really important that this occurs with all the 16 fervor that we can garner. We can do it through Alcoholics Anonymous; we can do it through Narcotics Anonymous; we can do it through MADD and SADD and all those acronyms that have been established. We must encourage social competency, where individuals themselves have clear values that have been communicated to them by parents and teachers and police and the courts and everybody else responsible for behavior. We must have emotional coping skills so that persons can learn to deal with stress, and when they have a stressful problem, they know avenues to use to get over that problem. Also important are good decision-making skills, communication skills, and certainly alternative highs. We also have to teach people how to be high off life or high off their productivity. This is really, really important. One other point that is terribly important and is associated with the problem of substance abuse is AIDS. In this country, as of January 19, 1987, 29,536 people had come down with AIDS, including 422 pediatric cases. That's tremendous. About 25 percent of those cases were from intravenous drug abusers, or the sexual partners of intravenous drug users. As a consequence, we are seeing transmission from intravenous drug users to heterosexual society. You don't have to be gay, nor do you have to be an intravenous drug user, to indeed come down with AIDS. In New York City, it was reported that one in every ten citizens now are positive for the antibody to the virus of AIDS. It also means that those people who are positive for the antibody are infectious. They are without symptoms, and if they have sexual intimacies with a person of either sex, they could pass on the virus and that person too will become positive for the virus. Twenty-five to 50 percent of those people who have the positive antibody will go on to get the disease. Twenty-five to 50 percent -- that is a startling number. We now feel that in New York City, there are about 250,000 to 500,000 people who are positive for the antibody to the virus. In certain Central African countries, i.e., the Central African Republic, Zaire, Rwanda, Uganda, as much as 5 to 10 percent of the population is already positive for the virus. And they don't practice homosexual sex; the sex distribution ratio is one to one, women to men. It has been reported that by 1991, at least in that part of the world, approximately 5 million to 10 million people may die from AIDS. We have to worry about that in this country, and not one state has been spared. There's a whole lot of denial going on because people say that AIDS is a disease of homosexuals and that it is a disease of intravenous drug users. We're going to see a great deal more of this problem and the issue must be addressed. One thing that is cause for concern, particularly for minorities in all of the major cities, is the heterosexual cases of AIDS. Among whites in the country, only 1 percent of diagnosed cases have been within heterosexuals. Among blacks, it is 12 percent. Among Hispanics, it is 3 percent of the cases. It is important to look at this because probably what is happening is we have a lot of in-the- closet gay or bisexual men, and we have a lot of in-the-closet intravenous drug users, where it takes a year or longer to find out that one's sexual partner is using drugs or having a homosexual relationship. We have to come out in the open with this problem. The biggest killer of males between 20 and 49 in New York City is, indeed, AIDS. There is a disproportionate representation of races. Ethnically, blacks make up 12 percent of the population in this country, and 25 percent of AIDS victims; and Hispanics are about 8 percent, but make up 14 percent of that AIDs victims. And this is because these minorities are disproportionately represented in the intravenous drug-using categories. The federal government has passed a law to give more money for drug treatment, although it's been cut back somewhat. There is a "Catch-22," though, regarding funding for drug abuse. If we had more money in New York City, we couldn't open more treatment programs because the people who live in the communities wouldn't allow us. They don't want more expansion of treatment programs, even though the problem is expanding greatly. If we could get over the resistance of communities, then we could be able to do something about the problem of drug abuse in New York. 17 H. Leonard Boche, Executive Director, Minnesota Association of Treatment Programs The states have faithfully been the custodians of public policy, which has taken the long-term view of alcohol and drug abuse problems while the federal government has declared intermittent all- out war and armistice depending on the election calendar and/or the state of public panic that may exist at any one time. The states are to be commended for their resolve and stability in the long- term struggle to find effective responses to the alco' 1 and drug abuse problem. A Comprehensive Viewpoint It is necessary to adopt a comprehensive view in which the distinctions made between alcohol and other psycho-active substances are seen as minimal. A generic approach is more consistent with the experience of the patients we see. There is no nationally accepted language for this viewpoint so we stumble about by using phrases like "substance abuse" or "chemical dependency" while the federal government maintains separate institutes and provides no leadership for a comprehensive approach. Again, it is the states that have been the innovators and have provided the "big view." If this task force could help develop a national language for the generic approach to alcohol and drug problems, it would be a historic achievement. During appropriation season there is a strong temptation to pit prevention against treatment as if these two elements are antithetical. That view is rejected here, for prevention and treatment are inseparably part of the same cloth. In the history of civilization's efforts to deal with public health threats, it is found that treatment for the disease often is found before means of prevention are discovered. It is not unusual for the means of prevention to be learned from the experience and insights of treating the victims. Commitment to treating the casualties of substance abuse gives credibility to prevention efforts. In Minnesota, the credibility of school prevention programs soared when school districts established employee assistance programs for administrative staff and faculty. Kids respond to consistency and are quick to pick up on hypocrisy. Sound prevention programs aré built on the foundation of a humane attitude that includes treatment of those who become dependent and addicted. There are two cliches that are continually being reinforced as more data becomes available -- namely, treatment doesn't cost, it pays, and you can pay me now or you can pay me later. The work of Holder and Hallen in the longitudinal study of Blue Cross subscribers in northern California found that treatment of alcoholism resulted in significant reductions in utilization and cost of all health care - not only for the alcoholic, but for the non-alcoholic family members as well. Treatment of alcoholism was not just humanitarian, but it reduced the health care costs of alcoholics and their families to the point of being less than the control group. The treatment of alcoholic people didn't cost, it paid. (Harold Holder and Jerome B. Hallen, H-2 Inc., 211 N. Columbia Street, Chapel Hill, N.C. 27514) Similar findings are reported by Gary Graham, M.D., medical director for Kemper Insurance Group, Chicago, Illinois. The 1985 report of the Chemical Abuse/Addiction Treatment Outcome Registry (CATOR) prepared by the Medical Education and Research Foundation of the St. Paul-Ramsey Medical Center reported on the six and twelve-month follow-up of nearly 3,000 persons treated for chemical dependency. That report summarized their findings by stating, "In addition to the obvious benefits to individual patients and their families, treatment programs appear to offer significant economic rewards to local, state, and federal governments, as well as insurance providers and private industry." (Norman G. Hoffmann, CATOR, 640 Jackson Street, St. Paul, Minnesota 55101) The CATOR study further points out that society incurs substantial costs for persons who are actively chemically dependent and that the drain of resources is curtailed when intervention occurs and society invests in treatment. 18 A Continuum of Care An effective treatment system is based on the understanding that recovery is a two-year process in which the patient will use a variety of services with varying degrees of intensity. There is no quick fix nor is there one miracle methodology that is so superior as to exclude consideration of others. The programs that closely tie together formal treatment with self-help aftercare seem to be most effective in helping people to recover. The resulting continuum of care will have within it four functions: case finding and intervention services; emergency services and detoxification; primary treatment; and aftercare. Case Finding/Intervention Services. A broad range of community "gate keepers" often are the people turned to in times of crises. Gate keepers who are sensitive to and knowledgeable about substance abuse are often key actors in getting families and dependent people in touch with the appropriate treatment resources. Formal intervention services are often crucial in helping the person to accept help. Employee assistance programs have proved to be cost-effective for both public and private employers. Rarely do people come for help "voluntarily," but rather accept help as the result of a crisis. The task of intervention services is to channel the energy of a crisis into constructive outcomes. This task becomes easier when the social stigma is reduced and there is a cultural understanding that chemical dependency is a treatable condition. Emergency Services/Detoxification. Toxicity resulting from an overdose of alcohol or other drugs can be a life-threatening condition. The first task of a detoxification program is safety. It has been found that specialized services for intoxicated persons serve their needs more efficiently than do general purpose emergency services. The key to the management of the intoxicated person is easy access to the service. The admission process must be quick and sure, operating under standing orders that take into account the needs of the intoxicated person and administered by people who have the ability to relate to the presenting person in a nonjudgmental manner. General purpose emergency services tend not to meet these conditions. Another major function of detoxification is to help the person to accept help and to refer the person to appropriate services. Primary Treatment. Primary treatment is that set of learning and therapeutic activities following detoxification where the patient is introduced to his or her illness and given the tools to stay sober. Two of the ingredients are hope and a discipline of recovery. The goal of primary treatment is to prepare the person to effectively use an aftercare program. The one factor that most clearly predicts success in treatment is the patient's willingness and ability to use the aftercare services. Primary treatment can be hospital-based, freestanding, residential, or outpatient. The level of environmental control required for a particular patient is a hotly debated issue at this time. The historic models relied very heavily on residential treatment, which was effective and economical. Because health insurance providers would pay for treatment only if it were in a medical facility, treatment moved into higher-cost settings in order to get payment for services. Now health care planners are telling the field that residential chemical dependency treatment is too expensive and that treatment has to be delivered on an outpatient basis. It must be pointed out that inpatient chemical dependency treatment became expensive as the result of the health insurance industry's insistence that treatment be more medical as a precondition for payment. The patient cannot be permitted to be a pawn in this debate, but must be provided quality care, whether residential or outpatient. Aftercare. Aftercare is crucial to success in treatment, for it provides the framework for the learning started in primary treatment to be internalized. For some patients more formal therapeutic aftercare is indicated, while other patients will do well with self-help groups such as Alcoholics Anonymous or Narcotics Anonymous. 19 Some patients will not have a home to return to, or, in some cases, the family will be so injured that return to them would be ill-advised. These persons will benefit from residential aftercare or a halfway house. Some patients need more time in a structured supportive setting in order to break the pattern of chemical dependency and start life anew. The halfway house helps the person use community resources appropriately and provides for the orderly reentry into the community. Problem Solving People who suffer from substance abuse develop lifestyles that are filled with problems, i.e., job, family, court, financial, etc. The temptation is to look at these problems as the cause of the substance abuse, when in fact, these problems may be the result of the illness. Major assistance in problem solving needs to be made available to patients after they have established basic patterns of sobriety. Problem-solving help given to actively using chemically dependent persons usually is misapplied. Basic Understanding of Alcoholism and Drug Abuse Clinical observations, more recently supported by additional research, recognize that chemical dependency is disproportionately found in certain family lines, as is true with diabetes. There is new appreciation for the presence of a genetic component in the development of alcoholism. The old adage that some people are born alcoholics seems to have a basis in fact. We live in a drinking culture and that, coupled with the presence of prescribed and recreational drugs, means that there is nearly universal exposure to psychoactive substances in the American culture. This nearly universal. exposure, placed against a substantial genetic pool of persons disposed toward uncontrolled use of such substances, results in a disease phenomenon. Over the past 40 years, we have learned that the condition is treatable, that people do recover and return to full productive lives, and that treatment doesn't cost, but rather it pays! Treatment also creates the hope upon which prevention efforts can be built. David L. Armstrong, Attorney General, Commonwealth of Kentucky The crime of drug abuse is a crime that arouses great passion and emotion. But it is also an economic crime, a crime of supply and demand. There are many ideas that relate to education and prevention, as well as early intervention and treatment. These ideas are aimed at cutting off the "demand" for drugs. But to complete the program, we also must work to cut off the "supply." Staggering profits are the incentive for drug trafficking, and to eliminate the problem, we must eliminate the profit. To confront and defeat alcohol and drug abuse, we need a multifaceted approach to a complicated problem. The following recommendations are based on years of discussions with law enforcement professionals: Law Enforcement Education. Law enforcement officers should be educated on alcohol abuse. Through education, we can recondition law enforcement officers to deal more effectively with drug and alcohol abuse. Presently, the training is inadequate. For example, in Kentucky, 400 hours of training are required for law enforcement officers. Out of that 400 hours, only four hours are dedicated to substance abuse. We need to provide law enforcement officers with more adequate training as to drug and alcohol abuse, and to provide updated training and information on a regular basis so that they can be fully prepared to play an effective role in confronting alcohol and drug abuse. Judicial Training. Training on drug and alcohol abuse should be provided to prosecuting attorneys and judges. This training, which could involve the attorney general's office in cooperation with the state agency responsible for substance abuse programs, could be conducted on 20 an annual basis for local prosecutors and judges specific to identification, prevention, and early intervention strategies. Also, information on diversion programs for offenders charged with drug and alcohol abuse would be helpful to the local prosecutors and judges. The rationale for this type of training would be that in an effort to identify, intervene, and direct the drug and/or alcohol offender toward appropriate treatment, the attorneys, prosecutors, probation and parole officers, and judges need to be more aware and up-to-date on drug and alcohol programs and strategies. Dram Shop Laws. States should be encouraged to enact dram shop law. This would be designed to reduce the serious injuries and deaths resulting from drunken driving by encouraging retailers of alcohol to act responsibly in the conduct of their business. Incentives within the model act could potentially encourage licensees not to serve minors and to intervene with problem drinkers so that they do not become intoxicated and operate a motor vehicle. The Dram Shop Act also could serve as a means to compensate innocent victims of drunken drivers. In many cases, innocent victims have no recourse against intoxicated drivers because the driver may be "judgment-proof." The Dram Shop Act would place the burden of compensation upon licensees who have acted irresponsibly with knowledge that their actions directly endangered others. A "responsible business practice defense" could be included to protect establishments against unfair lawsuits. Elementary Education. Law enforcement officers responsible for drug law enforcement could be utilized to make presentations to fifth and sixth grade students as to the legal consequences of drug experimentation. It would seem important to reach the students at the elementary school age, prior to the time when many of the students begin experimentation. Drug and Alcohol Law Review. Laws proscribing the use of alcohol and drugs should be reviewed for their adequacy. The sanctions prescribed by these laws may be adequate, but the enforcement of these laws and imposition of the prescribed sanction may provide room for improvement. It seems that too few drug offenders go to prison. Too few drug offenders are required to attend drug treatment programs as a condition of probation. To get tough on drug offenders, we need a unified approach. Police officers, prosecutors, and judges need to work together to make examples of some of the more serious drug traffickers. Usually, it is the street dealers, who are junkies themselves, who get busted. The big drug dealers who are higher up the chain of distribution rarely get caught. Law Enforcement Cooperation Greater cooperative law enforcement efforts are needed among local, state, and federal law enforcement officials. There needs to be regular meeting and exchange of information as to specific cases and drug offenders, who are often on the move among jurisdictions. By comparing notes, law enforcement agencies can help each other and bolster their cases. The suggested cooperative law enforcement efforts to exchange information should be on the regional as well as statewide level. Sometimes we hear of problems with turf battles and lack of trust between law enforcement agencies. As a result, this regular cooperative exchange of information and meetings should be strongly encouraged in each state so that we deal with the real enemy -- the drug trafficker. Realigning Priorities Police administrators need to consider realigning priorities to use a greater amount of their limited resources for drug law enforcement so as to create a long-term effect. Of course, given the competing law enforcement interests that each police administrator must confront, the basic need here is additional funds to effectively provide drug law enforcement. Asset Forfeiture Statutes Better use of the asset forfeiture statutes is needed at both the state and local law enforcement levels. These statutes can permit confiscation of property used to further the crime, as well as the 21 "fruits" of the crime. Examples would be confiscation of vehicles, property, bank accounts, drug money, etc. Under forfeiture statutes, confiscation of these kinds of drug assets go to the law. enforcement agency responsible for the enforcement of the drug laws against the particular offender. Enforcement of forfeiture statutes is very important to take the profit out of crime. Also, it provides one source of additional funding for drug law enforcement. There also a federal forfeiture statute. If the cooperation among federal, state, and local drug law enforc: ment agencies can be encouraged, this can be a strong tool in the effort to take the profit out of drug crime. Targeting Law Enforcement Resources The law enforcement effort to more effectively reduce the supply of illegal drugs will not be without its costs. State and local governments need more money to devote to drug law enforcement. Specific needs include the following: More manpower. For example, there are no more than sixty law enforcement officers in Kentucky who work full time on drug law enforcement. More money. Funding is needed to coordinate various law enforcement agencies to encourage cooperation, information sharing, and the compilation of information and regular dissemination of this information to the local law enforcement agencies. The coordinating agency should go around the state and conduct regional meetings with local law enforcement personnel to provide a forum for this cooperative effort. Equipment. More and newer equipment is needed, such as law enforcement vehicles that are not readily identified as such, radios, and surveillance equipment. Drug-Buy Money. This is needed to entice the offender, especially to get the large drug traffickers, who usually deal in large sums of money. Larger drug-buy funds are needed to entice the larger offenders. Drug law enforcement personnel rely upon informants. Informants do not talk for free, and often it is necessary to provide them money. Therefore, to make greater use of informants, greater sources of informant compensation are needed. Beverage Penalties. Alcohol Beverage Control administrators should render severe penalties to licensees' repeated convictions for the sale of alcohol beverages to minors. Undercover Programs. The development and coordination of programs for the exchange of undercover police officers between local jurisdictions for major investigations should be encouraged. Prescription Drug Controls. Strong prescription drug laws should be enacted to discourage the illegal use of prescription and designer drugs. Law enforcement has made a beginning. Most state police departments have an effective investigative team. Local police agencies also in many cases have developed units to concentrate on the investigation of drug trafficking. But the problem has grown faster than the solution. Drug abuse and drug enforcement are local problems that need to be solved locally. To solve them, both federal and state financial assistance is needed. But that money is needed on the local level, as this is where the problems are and where they can most quickly be identified and confronted. 22 Today, there are some good examples of the team approach to this problem. The solution is not an easy one. It takes commitment by many different people with many different ideas and skills. It takes the commitment and solid prevention and education programs. It takes the commitment of law enforcement to work together. It takes the commitment of solid intervention and treatment programs. It takes the commitment of expanded funding. We can all work together to reduce the supply of illegal drugs, take the profit out of drug crime, and ultimately win the battle against drug abuse. Alex Brodrick, Executive Director, Volunteers of America, Louisville/Lex- ington, Kentucky For too many years, drugs and alcohol have shattered lives, destroyed families, and ruined the hopes and dreams of many in our country. In particular, alcoholism among the poor should be cause for great concern. Those who have few or no advocates and those for who are all too easy to overlook have felt the consequences of the failure to have treatment. It is the poor who feel the critical blunt of disappearing resources and unattentive governments. Only a few short years ago, approximately ten, the problems of alcoholism among the homeless and poor were treated in Kentucky and other states of the nation through a network of programs commonly known as state hospitals, detoxification centers, halfway houses, and residential treatment centers. In each of the programs, treatment of alcoholism was available to all, and even the poorest American could detoxify and find a rehabilitation center in which to continue his life-threatening struggle for sobriety. While there were people on the streets, their numbers were lower and each of them had the opportunity to receive help for their alcohol problems. Today, most of those opportunities are gone. Our federal government has focused on deinstitutionalization from state hospitals and put literally thousands of people on the street with no place to go. The government has also decided that the judicious expenditure of federal dollars does not include treatment services to the poor alcoholic, especially any type of intermediate or long-term assistance in institutions or halfway houses. Unfortunately, many states followed suit and quickly a fully developed network of detoxification programs, halfway houses, and institutions faded from the scene. These were replaced by mandated health insurance for alcohol treatment, increased outpatient alcohol services at comprehensive care centers, high-cost medical alcohol treatment centers, and sophisticated attempts at prevention aimed at educating America about the pitfalls of alcohol abuse. All these programs worked to some degree and continue working today, but none of them took into account the poor or nearly poor person with an alcohol problem. With the changes, those with money found increased opportunities for care and those without found "the street" and no relief from the bottle. They became the disenfranchized poor. More than 50 percent of the people on the street in our cities are suffering from alcoholism, and an even larger percentage have serious alcohol problems. The population of those on the street has increased dramatically in the last ten years. Our prison system and county jails are jammed beyond capacity, and an increasing majority of the admissions to jails are for alcohol-related offenses. The cost of jails increases as do services to street people, and more and more street people die daily in dumpsters of heart failure, of liver disease, and of alcoholism. A serious look must be given to alcoholism among the poor, for they are disenfranchised and have no strong lobby for their needs. My recommendations include the following: First, that the National Governors' Association choose to challenge government and their allocation of resources; Second, that the National Governors' Association take the unpopular position of proposing the redevelopment of alcohol services to the poor; 23 Third, that the National Governors' Association consider the needs of those who are poor when looking at recommendations for education, intervention treatment, and law enforcement; and Fourth, the National Governors' Association take the lead in advocating for the poor in the critical area of alcohol and substance abuse. If the lead is not taken by NGA, it may not be taken at all, and the problems surrounding alcoholism, the poor, and the streets will continue to take its tragic toll on the lives of our fellow Americans. Judge Andy Devine, Juvenile Judge, Lucas County Juvenile Court, Toledo, Ohio Let us keep in mind Governors taking a lead role. A Governor has considerable power and influence in the Legislature and over the various departments and the leadership of those departments. If Governors have an understanding of the substance abuse problem, they can make a very, very significant contribution toward turning this problem around. Parents, too, must take a lead role. They are the most important ingredient, the most important component of prevention of risk behaviors. Parents are the hub of the wheel. Community commitment, too, is critical. They are the spokes of the wheel and include schools, mental health institutions, churches, the police, the courts, and everybody else supporting parents, understanding the role of parents, and helping them in this awesome task of rearing their children. These "spokes" should not raise their children for them, but with them, and should hold them accountable for their parenthood. The juvenile court system can be used to mobilize parental accountability. If, for example, a child is consistently truant and benign efforts to get that child back in school have failed, a brief stay by the parent in the county jail typically will turn this situation around. We must say to parents, "it's your job, not our job, nor the teacher's job, to get that kid in school every day on time." In addition to establishing and assuring parental accountability and fostering and nurturing a sense of community commitment, we must not wear out or burn out. It will take a lot of time and bear a lot of heartache to change a risk behavior such as substance abuse. But, we've got to hang in there if we are ever going to change it. 24 PART TWO: Alcohol and Drug Abuse Prevention: From Knowledge to Action Prepared by: Judith E. Funkhouser Associate Director for Program Development Division of Communications Programs Office for Substance Abuse Prevention and Sharon Low Amatetti New Products Coordinator National Clearinghouse for Alcohol and Drug Information 25 FORWARD The concern over the nation's alcohol and other drug problems has reached every segment of society. As a result of this national concern, the Anti-Drug Abuse Act of 1986 was signed into law (P.L. 99-570), creating the Office for Substance Abuse Prevention (OSAP). This office directs the federal effort in the prevention field by increasing knowledge about and promoting effective strategies to deal with alcohol and drug problems. In carrying out this responsibility, OSAP is pleased to have an opportunity to provide assistance to the states through this collaborative effort with the National Governors' Association. The success of prevention strategies will depend on the active and continuous involvement of entire communities, using many support systems. Prevention cannot be accomplished solely within the confines of a single organization. To elaborate, a support system within a community consists of parents; youth; and federal, states and local governments working through schools, law enforcement, human service, and health agencies. Other essential elements include sports and entertainment personalities, media and print specialists, business and industry, and volunteer organizations. The models summarized in this document can simultaneously guide new efforts and provide a framework for analyzing common and diverse experiences. The guidelines represent the consensus of OSAP prevention strategies based on knowledge and evaluation of prevention efforts to date. Like the theories and models that have contributed to formulations of the guidelines, I expect, these principles will be expanded and refined in the future, based on the findings of new prevention efforts. As you read through this document, please be aware that evaluation efforts of existing and new prevention models and strategies are underway. Problems can develop when untrained personnel use untested and/or inappropriate materials. Such problems can be avoided by working with community members to gather, organize, and review the problems in your state and communities before adopting a prevention strategy. OSAP will be updating this information as more evaluation is completed and will be expanding the paper to include examples for booklets and other materials designed to promote drug-free communities. We look forward to working with you toward this important goal. Reed Bell, M.D. Acting Director Office for Substance Abuse Prevention Alcohol, Drug Abuse, and Mental Health Administration U.S. Department of Health and Human Services 27 INTRODUCTION This paper was developed by the Alcohol, Drug Abuse, and Mental Health Administration's Office for Substance Abuse Prevention (OSAP) to serve as a reference point for planning strategies to combat alcohol and other drug problems in our states and communities. Following an "Overview of Alcohol and Drug Problems" in our society, the "Background" of comprehensive prevention strategies is elaborated. "Theories and Models for Current Prevention Approaches" sets forth the rational bases from which today's prevention strategies are derived. Because prevention is an evolutionary field that is continually growing from the thinking and experiences of its planners and practitioners, the current body of knowledge may be expected to expand even as it is applied in our states and communities. The models summarized in this document can simultaneously guide new efforts and provide a framework for analyzing common and diverse experiences. Finally, this paper suggests specific "Guidelines" for planning strategies to prevent alcohol and other drug problems. These guidelines represent the consensus of OSAP prevention strategists based on their knowledge and evaluation of prevention efforts to date. Like the theories and models that have contributed to formulation of the guidelines, the guidelines themselves may be anticipated to be expanded and refined according to the experience of the new prevention efforts. 29 OVERVIEW OF ALCOHOL AND DRUG PROBLEMS According to a recent epidemiological assessment, deaths resulting from substance addiction account for an annual loss of more than 300,000 lives due to smoking; 100,000 lives due to alcohol consumption; and 30,000 lives due to use of other drugs. Alcohol and drug problems may be associated with acute use (e.g., automobile accidents), chronic use (e.g., liver cirrhosis), or a behavioral pattern of chronic use known as dependency. In the past decade, a greater number of teenagers have used alcohol and a variety of psychoactive drugs, and first use of these substances has occurred at increasingly younger ages. Tobacco, alcohol, and marijuana are seen as "gateway" drugs to later use of and greater involvement with a variety of substances that may lead to chemical dependency. The estimated annual cost to our society of alcohol and other drug problems (excluding tobacco) is approximately $205 billion, of which $140 billion is attributed to alcohol abuse and $65 billion to abuse of other drugs. This represents approximately $850 per person in the United States and includes costs for lost productivity, crimes, accidents, fires, treatment, and various indirect expenses. This dollar estimate cannot begin to measure the personal and emotional suffering experienced not only by the abuser, but also by family, friends, employers, and coworkers. The lifetime cost of a single alcohol and drug abuser currently is estimated at $85,000 in lost productivity and direct economic burdens on society; hence, prevention of drug abuse problems in even one youth can have sizable economic returns. The lifetime cost of a single case of Fetal Alcohol Syndrome is estimated at $596,000. Included in this estimate are expenditures for health and education, together with losses in market and household productivity. Large economic benefits from successful prevention efforts, therefore, can be realized. OSAP has determined that the greatest savings by far can be realized by targeting youth and those who influence their knowledge, attitudes, and behaviors. Research has demonstrated that: Alcohol and other drug-using attitudes are formed during pre- and early adolescence. Almost no use of cigarettes, alcohol, or illicit drugs (except cocaine and abused prescription drugs) is initiated after age 25. Life expectancy has increased for every age group in the U.S. except 16- to 24-year-olds. For these reasons, this paper emphasizes strategies that are designed to prevent the use of alcohol and other drugs by America's youth. 31 BACKGROUND Over the years, researchers have identified multiple causes of alcohol and other drug-related problems. Genetic, behavioral, personality, environmental, cultural, and economic variables at one time or another have been examined independently as contributors to drug and alcohol abuse problems. More recently, these variables have been viewed as interwoven components of a complex pattern that requires comprehensive approaches. Accordingly, new emphasis is directed to examining the personal and social characteristics of individuals, families, and groups in relation to such societal or contextual factors as business structures and community "norms," standards, and expectations. The result is the evolution of integrated prevention approaches that are, at the same time, broad in scope and specific in their sensitivity to individual and cultural attributes. Comprehensive and integrated prevention approaches are strongly recommended to develop awareness and educational programs, to reinforce social and legal policies, and to promote social and organizational structures that foster healthy, safe, and meaningful lifestyles. Such approaches emphasize a shared responsibility for addressing alcohol and other drug abuse problems and the need for long-term planning as well as for short-term crisis intervention. By definition, comprehensive approaches acknowledge that individuals function within broad social and physical environments and may be expected to respond differently to different interventions into their alcohol and drug use patterns. For example, it is already well documented that: License revocation is a more successful intervention than educational efforts for intoxicated drivers.' Increasing the price of alcohol has an impact on youth as well as on adults and on heavy drinkers as well as on social drinkers. Raising the minimum drinking age is effective in reducing alcohol-related traffic fatalities among youth. Laws providing sanctions for intoxicated drivers must be accompanied by extensive awareness programs and enforcement efforts to be effective. School-based programs are receiving mixed reviews in the literature, with some speculation that delayed onset and decreased use result from activities that allow students to more correctly assess their peers' attitudes toward smoking, drinking, and other drug-use and allow a social norm of non-use to develop and be reinforced. Comprehensive approaches also take into account the learning environments of individuals. Television, for example, has become a familiar fixture in the home. Health promotion and 33 employee assistance programs are multiplying at our worksites. Schools and families appear to be assuming increasing responsibility for health and social learning opportunities. In short, for the times in which we live, to address a problem that affects every level of individual and societal functioning, only approaches that work at every level can be expected to yield positive results. Theories and models that work to support the development of comprehensive approaches are presented in the following section. 34 THEORIES AND MODELS SUPPORTING CURRENT PREVENTION APPROACHES Models are derived from a body of research and allow us to generalize from one set of circumstances to the next. The models and theories presented here derive from a base of knowledge that, although usually associated with one or several researchers, has been expanded upon by numerous other researchers and practitioners. The models and theories selected for inclusion in this document appear to capture the latest thinking of the prevention field and should prove useful both for developing prevention programs and for assessing prevention approaches and products currently in the marketplace. Suggested guidelines developed by the Office for Substance Abuse Prevention follow the presentation of these models. Learning Models Social Learning Theory and Modeling (Bandura) Albert Bandura's "Social Learning Theory" builds on the work of B.F. Skinner, who originally described the process of learning as a response to rewards and punishments. According to Bandura's theory, learning is acquired and shaped by the positive and negative reinforcements resulting from one's own behavior, as well as by observation of other people's behavior and its consequences for them. Bandura also notes that the ability to anticipate both the consequences of one's behavior and the attitudes of other persons toward such behavior develops as an individual matures. This ability allows persons to self-regulate or internalize rewards and punishments and to serve as agents of their own behavioral change. Bandura recognized the potential for using "modeling" as a way of directing and changing behavior. We observe the behavior of others in person, on television, and by means of other communications media. The more attractive and competent a model is, the more likely others are to adopt that model's behavior. "Near peers," who are slightly older than the target audience and who resemble the target audience, often are used in educational programs to transmit messages by depicting behavior and attitudes that young people would like to imitate. Cognitive Inoculation, Behavioral Commitment, and Cognitive Dissonance (McGuire) William McGuire has outlined procedures for developing and maintaining attitudes, values, and beliefs that favor non-use of unhealthy substances. These procedures are called "pretreatments" because they are applied before a behavior is adopted or experimented with and are not designed for youth already using alcohol and other drugs. 35 "Cognitive Inoculation" is one of these pretreatments. Cognitive inoculation prescribes that lessons concerning attitudes and beliefs about alcohol and other drugs be accompanied by a discussion of the conflicting attitudes and beliefs that a student might encounter in the future. This teaching method prepares students for, and thereby protects them from, pressure to adopt beliefs and attitudes that may be unhealthy. Another pretreatment approach requires that a "behavioral commitment" be made on the part of the individual. Commitments can take the form of a private decision, a public announcement of one's beliefs, active partic nation on the basis of the belief, and commitment based on awareness that someone else is committed to the belief (external commitment). McGuire was surprised to find that external commitment was stronger than a private commitment in most cases - convincing evidence for the power of peer, parental, community, media, and societal support for non-use behavior among youth. In addition, McGuire found that, in general, people want their attitudes and beliefs to be compatible with their behavior. If they are not, there is "cognitive dissonance" that a person will want to eliminate. For instance, if an adolescent strongly values his or her athletic ability, to successfully attach the belief that smoking marijuana diminishes this ability would create dissonance. Resolution of dissonance would require the individual either to abstain from smoking marijuana or to place a lower value on athletic ability. Connecting new beliefs about alcohol and other drugs to existing cognitions, if used as a pretreatment or prevention measure, requires a clear understanding of the cognitions students holds important. Social Inoculation Theory (Evans) Richard Evans' "Social Inoculation Theory" extends McGuire's theory to address the many social influences, beliefs, and attitudes that create pressure on a young person to use alcohol and other drugs. Such pressures might include, "If everyone is doing it, it can't be bad," or joining a group that, by its use behavior, exerts pressure on the young group member. Students are instructed about social pressures to use alcohol and drugs and are assisted with the development of skills to resist the pressures. Mary programs based on the Social Inoculation Theory use modeling, as suggested by Bandura, to teach peer resistance skills. Others encourage public commitments from students as an added incentive to resist negative peer pressure and as positive social reinforcement for the group as a whole. Behavioral Development Models Development Model (Erickson) Eric Erickson argues that psychological development occurs in identifiable stages throughout the life cycle. In order for one to develop a healthy personality, the psychosocial "crises" associated with each stage of development must be successfully resolved. In the first year of life, for example, a child must develop a sense of trust rather than mistrust. Similarly, autonomy (versus doubt) must be developed in early childhood (2-3 years of age); initiative in play (4-5 years of age); and, industry, during the elementary school years. Erickson argues that the major crisis to be dealt with in adolescence is that associated with establishing identity and avoiding identity diffusion. Adolescence is a period of transition. Erickson calls it a period of role confusion out of which identity should emerge. The individual who has previously accepted his or her role as a child now attempts to adopt some aspects of the adult. Certain adult behaviors, such as being sexually active, smoking, and drinking alcohol, are considered deviant because they are essentially adult behaviors exhibited at an earlier stage of the life cycle. A second aspect of role confusion involves the adolescent's developing self-image. The adolescent's body changes rapidly. The rapid physical change cause the young person to feel 36 clumsy and ill-at-ease. These physical and social changes often result in a poor self-image among adolescents and in excessive concern about acceptance by others, especially peers. The identity crisis also is marked by changing relationships with parents. As adolescents break away from the previously close personal guidance of their parents or guardians, they seek support elsewhere, usually with a peer group. In this developmental context, smoking and using alcohol and other drugs may appear to the young person as a way of expressing a growing sense of independence. Behavioral Intention Theory (Fishbein and Ajzen) Martin Fishbein and Icek Ajzen have developed a system of quantifying attitudes because, like others, they believe that attitudes are logical determinants of behavior. Their theory states that, when measured properly, attitudes and subjective norms held by an individual can be used as predictors of behavioral intent and of behaviors. Attitudes are the beliefs a person holds about the outcome of a behavior along with the value he or she places on that outcome. Subjective norms are the individual's assumptions about the views of significant others regarding the behavior, along with the individual's motivation to comply with these views. In order for attitudes and subjective norms to be good predictors of behavior, their measurement must be in terms of specific behavioral situations, e.g., a person drinks (action) beer (target) in a car (context) on the weekend (time). Attitudes and subjective norms must be assessed keeping the action, target, context, and time in clear focus. This measuring technique ensures that the content of messages used to change attitudes is relevant to the target group and that adequate attention is given to the strength of social influences on behavior. This theory provides a good framework for understanding the important role that perceived social norms play in directing behaviors. For example, adolescents generally perceive a prevalence of alcohol and drug use among their peers that far exceeds actual consumption. Students who overestimate the use of alcohol and other drugs may view use as "normal" and may be more accepting of such use. Social Development Model (Hawkins) David Hawkins and his colleagues have developed a "Social Development Model" that seeks to address key risk factors for alcohol and other drug use at developmentally appropriate points. Hawkins advocates providing a young person with opportunities for active involvement, skills for successful participation, and a consistent system of rewards and punishments. According to the Social Development Model, this practice will lead to the development of bonds of attachment, commitment, and belief between young persons and the social units (families, school classrooms, or groups of friends) in which they participate. The model also suggests that when a social unit's expectations or norms for behavior are clear, young people will be less likely to violate these expectations, particularly if they feel socially bonded to the unit. According to the Social Development Model, prevention programs should seek to increase opportunities for active involvement in family, school, and positive peer groups; ensure the development of skills needed to perform successfully in childhood and adolescence; and ensure that children's social environments provide clear expectations and consistent reinforcement for behavior. Health Behavior Theory (Jessor and Perry) The formulation of Richard Jessor and Cheryl Perry's "Health Behavior Theory" follows in the tradition of Karl Lewin's Field Theory, which emphasizes the unique developmental history each person brings to a situation and, at the same time, the similarities among people due to common circumstances. Like Lewin, Jessor and Perry take great care to specify the variables and relationships among variables that influence behavior .. specifically, health behavior -- in order to address multiple 37 behaviors. Health is comprised of four domains: physical, psychological, social, and personal. Because a single behavior can affect several of these health domains, their relationship must be examined fully in terms of prevention strategies. Jessor and Perry recommend two strategies for prevention: 1) weakening or eliminating behaviors that compromise health; and 2) strengthening or introducing behaviors that enhance health. These complementary strategies are the products of a prevention focus directed toward achieving a balance in an individual's entire behavioral functioning. Because a covariation exists among a number of health-compromising behaviors, i.e., adolescents engaged in one of severil risky behaviors are more likely to be involved in others, preventing or eliminating any health- compromising behavior may have an effect on other behaviors. The promotion of health-enhancing behaviors includes the understanding that alcohol and other drug use may be serving as a way to gain independence from parents; with this understanding, new and healthier behaviors that serve the same purpose may be introduced. Stages of Drug Involvement (Kandel) Denise Kandel and her colleagues describe drug use as a process of clear-cut stages and largely determined by a matrix of social relationships. Different influences are involved at different stages, with situational and interpersonal factors most important for initiation into drug use behavior and psychological factors most important for increased involvement or participation in that behavior. Three specific stages of drug use described by the researchers are: 1) use of liquor, 2) use of marijuana, and 3) use of other illicit drugs. Distinct predictors mark initiation into each stage of use. The most important predictor of liquor use is the involvement of a youth in minor delinquent activities. Young persons with beliefs and values favorable to marijuana use and also are associated with friends who use marijuana are more likely to enter the second stage of drug use. Parental factors, feelings of depression, and contact with drug-using peers are the primary predictors of illicit drug use. Misuse as a Deviant Response (Kaplan, Martin, and Robbins) Kaplan, Martin and Robbins' model is an explanation of deviant behavior that, inasmuch as drug use in adolescence is an example of deviance, provides one explanation for such use. The researchers note that deviant responses are motivated by the adolescents' earlier development of self-rejecting attitudes. These attitudes result from unhappy or unsatisfying normative participation in a variety of interpersonal or social interactions. According to the researchers, repeated self-devaluing experiences in membership groups will take away personal motivation to conform with nominative patterns of behavior. When normative patterns of behavior are no longer motivationally accepted responses, deviant patterns represent alternative responses by which an individual can act effectively to boost self-esteem. Drug use is more visible if it is prevalent among peers at school or in the neighborhood. An individual's perception of the likelihood of self-enhancing consequences resulting from a particular pattern of drug use also reflects such variables as perceived attitudes toward the pattern of drug use held by positive and negative reference groups; the visibility of more or less prevalent adverse consequences of use; the perceived compatibility of consequences and concomitants of the drug use pattern with behavior appropriate to valued social roles that are not themselves the basis for one's rejection; and the ability to justify use without experiencing overwhelming feelings of guilt. Sensation-Seeking as an Explanation for Drug Use (Zuckerman) Marvin Zuckerman's research has explored the relationship between an individual's need for sensory stimulation and a host of behaviors, among them the use of alcohol and other drugs. He 38 observes that all individuals look for varied, novel, and complex experiences, but have different optimal levels of arousal. Stimulation serves different functions. Zuckerman found the primary functions to be: offering thrills or adventure; providing new experiences; facilitating disinhibition; and reducing boredom. Using alcohol or other drugs, eating, smoking cigarettes, and engaging in sexual activity are all sources of sensory stimulation arousal. Individuals who have strong sensation-seeking tendencies are more likely to engage in these activities and to a greater extent. The most important demographic correlates with sensation seeking are age and sex. Thrill or adventure-seeking and disinhibition-seeking declines after age 30. Males generally score higher on all sensation-seeking scales except for experience-seeking. Zuckerman has found that persons who experiment with a variety of drugs tend to score high on the sensation-seeking scale. Alcohol use alone, however, tends to be associated with a narrower kind of sensation-seeking, that of the disinhibition type. Communications Models Health Promotion and the Knowledge-Attitude-Behavior Continuum (Bettinghaus) Erwin Bettinghaus expands the original knowledge-attitude-behavior continuum by including research from Fishbein, McGuire, and others to suggest ways to improve health campaigns aimed at avoiding, maintaining, increasing, changing, or adopting new behavior. Evaluations of such campaigns have found that they are effective in gaining the attention and in arousing the interest of a target audience. Bettinghaus suggests that the knowledge-attitude-behavior model can be improved by using measures of behavioral intention (Fishbein) rather than generalized attitudes. In addition, Bettinghaus advocates addressing countermeasures (anti-smoking efforts that compete with pro- smoking print media messages); difficulty (losing fifty pounds is more difficult than reducing salt intake by 10 percent); addictive properties (of tobacco, alcohol, and other drugs); and social pressures (from peers). Finally, Bettinghaus proposes the use of McGuire's information processing model, which argues that moving between the elements of the knowledge-attitude-behavior continuous demands processing time on the part of individuals, as well as attention to a set of elements within a communication matrix. The matrix includes, at least, addressing attention, comprehension, yielding, retention, and action, while, at the same time, paying attention to the five elements of the communications process (source, message, channel, receiver, and destination). Communication-Behavior Change Model (Maccoby and Solomon) Nathan Maccoby and Douglas Solomon have studied mechanisms used by mass media campaigns to change behavior and have defined steps required to move a target population from initial awareness of interest in a problem to the adoption and maintenance of advocated attitudes or behavior. The first step involves attracting attention and focusing it on specific issues and problems, a process referred to by mass media researchers as "agenda setting," which, for major national campaigns, has been accomplished by broadcast media. Once a subject is on the public agenda and is perceived as an important issue, a campaign must explain the issue in a way that is personally relevant to individuals in the target audience; this step is referred to as "informing." The population also must be given positive incentives to change behavior, as well as support and encouragement to maintain new behavior ("motivation"). Once members of the population fully understand their personal relationship to the problem, they must be taught how to modify risk- related behaviors ("training"). Finally, if newly acquired habits are to be maintained, that maintenance must be accomplished by self-control ("self-maintenance"). Self-cuing at appropriate times and places is critical to the maintenance process. Variables that exert an influence on each of these processes include the receiver's age, sex, socioeconomic status, current health beliefs, and previous education. Prevention strategies must be 39 designed to take into account the full range of potential influences operating at the personal, community, and economic levels. Persuasion-Communications Model (McGuire) William McGuire also has worked extensively on theory underlying communication campaigns. He describes the components necessary to construct a communication capable of changing attitudes and behavior, along with successive responses persons must make if they are to "yield" to the communication. A communication is comprised of five variables: 1) source -- the characteristics of the individual from whom the message is perceived to be coming (which strongly influences the communication's credibility and acceptability to the audience); 2) message -- the context, how it is presented and organized, what is and is not included, and its length, speed of delivery, and other characteristics; 3) channel - the medium through which the message is delivered, i.e., print, radio, or television; 4) receivers - the target population; and 5) destination -- the type of behavior at which the communication is aimed. According to McGuire, the effectiveness of a communication campaign depends on its ability to lead an audience through a successive twelve-step process: 1. Being exposed to the communication. 2. Attending to the communication. 3. Liking or becoming interested in the communication. 4. Comprehending the message. 5. Learning how to incorporate the target behavior in one's life. 6. Accepting or yielding to the change. 7. Remembering the content of the message and remembering that one has agreed to it. 8. Being able to retrieve the information from memory. 9. Making decisions based on the retrieval of the information. 10. Behaving in accord with the decision. 11. Experiencing reinforcement for the behavior. 12. Engaging in postbehavioral activities, such as reorganizing one's related beliefs. Diffusion of Innovations (Rogers) Prevention often entails the introduction of new health-related ideas to members of a social system. The process by which new ideas or products are spread is called "diffusion." Everett Rogers has studied the diffusion process and has observed processes that both facilitate and impede diffusion. It is not critical that an idea or product be original in order for it to be considered innovative. Rather, it is the perceived or subjective newness of an idea to an individual that determines his or her reaction to it. New ideas can be introduced from within the social system or from outside. When introduced from outside, new ideas spread by selective contact change or through directed, planned change. Either way, the rate of adoption of a new idea is influenced by several factors, including: the degree to which the innovation is perceived as better than the idea it supersedes, i.e., its relative advantage; the degree to which an innovation is perceived to be consistent with the existing values, past experiences, and needs of the receiver, or its compatibility; the degree to which an innovation is perceived as difficult to understand and use, or its complexity; the ability to test the innovation before fully adopting it, or its trial ability; and the degree to which the results of the innovation are visible to others. Rogers notes that, if the stage of introducing a new idea is at the awareness or information level, mass media channels are the most rapid and efficient mechanism. If, however, the stage is at the attitude, the behavior change, or the "adoption point," then an interpersonal, face-to-face 40 interchange is much more effective. The most successful diffusion occurs when mass media are used to build awareness and reinforce newly adopted attitudes and behavior in conjunction with face-to-face interchanges for trying, adopting, and maintaining new attitudes and behaviors. Public Policy Models Price Policies and Prevention Other researchers are looking at the macroeconomic, environmental determinants of tobacco and alcohol consumption. For instance, two recent alcohol consumption studies, one by Cook and Tauchen and the other by Grossman, Coate, and Arluck, present the strongest evidence to date that consumption is responsive to changes in the price of liquor. Cook and Tauchen (1982) found that an increase in the liquor excise tax by a dollar per proof gallon reduces the cirrhosis mortality rate by 5.4 percent in the short run and by perhaps twice as much in the long run. (Liver cirrhosis rate provides a reliable measure for estimating chronic excess consumption.) This important finding addresses the skepticism that consumption by heavy drinkers, because it is habitual or addictive in nature, also is insensitive to increased taxation. Cook and Tauchen's findings suggest that, while heavy consumers of alcohol may adjust by purchasing less expensive brands, their overall rate of consumption also declines in response to increased taxes. Grossman and his colleagues (1984) found results compatible with those of Cook and Trauchen and demonstrated that price sensitivity effects are particularly prevalent among young people. The researchers found that a ten-cent increase in the cost of a six-pack of beer, a thirty-cent increase in the cost of a fifth of liquor, and a one-year increase in the legal age for purchase of beer had approximately the same impact on consumption. Similarly, Cook's work shows the connection between even small increases in excise taxes on hard liquor and reductions in fatality rates to alcohol-impaired driving and cirrhosis. Minimum Drinking Age Research also indicates that lowering the minimum age for purchase of alcohol is associated with an increased rate of automobile crashes among young people. Conversely, increasing the minimum age of purchase reduces the rate of automobile crashes among young people. Cook and Tauchen (1984) analyzed auto fatality rates for young people during the eight years between 1970 and 1977 in the forty-eight contiguous states, along with levels of availability of alcohol to young people in those states. They concluded that a reduction in the minimum legal drinking age from 21 to 18 years for all alcoholic beverages would increase the rate of auto fatalities for people between 18 and 20 years of age by about 7 percent and by somewhat less for 16- and 17-year- olds. Coate and Grossman also examined the effects of minimum legal drinking ages on alcohol consumption by young people ages 16 to 21 and found that frequency of consumption of beer, the most popular alcoholic beverage among youth, is inversely related to the minimum legal age for its purchase and consumption. The researchers estimated that a uniform minimum drinking age of 21 for beer in all states would have reduced the number of youths who drank beer four to seven times a week during the sample period by 28 percent and the number who drank one to three times a week by 11 percent. Other Restrictions on Availability Research into the physical availability of alcoholic beverages and other drugs has resulted in varying findings but generally supports the hypothesis that a reduction in availability is correlated with lower use rates and incidence of related problems. 41 MOVING FORWARD: SUGGESTED PREVENTION GUIDELINES Based on current research findings, the Office for Substance Abuse Prevention has developed the following guidelines for prevention planners. Taken together, the guidelines direct planners to the most important starting points for prevention efforts. Target High-Risk Families According to several researchers who have conducted longitudinal studies or reviewed state-of- the-art literature, youth raised in certain "family" environments are at high risk for becoming involved with use of alcohol and other drugs. Different environments appear to protect young people from involvement. High-risk factors include the following: families in which one or more adults are engaged in alcohol abuse or illegal drug use; families with permissive attitudes toward adolescent alcohol and drug use; families experiencing major stressors that can include separation or divorce, economic hardship, discrimination, or recent losses; and families who cannot adequately provide a protective environment for their children and adolescents. These families may not have the ability to teach age-appropriate mental, physical, emotional, and social skills; the ability to foster positive communication patterns, self-efficiency, and family bonding; the ability to deal with stress and overcome feelings of powerlessness, helplessness, and meaninglessness; or the ability to foster and promote prosocial bonding with schools, non-using and low risk-taking peers, and religious organizations. Families that appear to be better protected against engaging in health-compromising behaviors appear to have many of these characteristics in common: higher economic status; lack of parental alcoholism, criminality, and mental illness; children spaced at least two years apart; at least one involved adult caretaker (not necessarily a parent or guardian); 43 closeness and warmth combined with consistent rules and discipline and clear roles and responsibilities; literate parents who value and encourage education and prosocial bonding at school; and families who have access to financial resources, e.g., through employment. Parents who generally are cautious about drugs, do not engage their children in drug-taking behaviors, such as lighting cigarettes or opening beers, do not approve of alcohol or other drug use by youth, do not tolerate intoxication or illegal drug use by adults, do not use drugs to solve problems, and do not role-model high-risk alcohol or other drug- taking behaviors, create more protective environments for their offspring. A protective environment also is characterized by the nurturing factors listed above, such as closeness, involvement, and appropriate discipline. While it appears that some young people may be influenced by peer pressure to engage in alcohol and other drug-taking behavior even though they do not want to, other research suggests that some young people may be predisposed to engage in health-compromising behaviors when peer pressure is exerted. One study, for instance, found that the greater one's willingness to conform to antisocial peer pressure, the stronger the association between perceived pressures and self-reported misconduct and antisocial behaviors. Other researchers have found that there are certain individuals who are more predisposed to become engaged in risk-taking behavior that, during adolescence, often is associated with alcohol and other drug use. These youths have been described as "sensation-seekers" and presumably have low thresholds for boredom and routine, as well as special needs. According to the researchers, the act of engaging in excessive risk-taking behavior can help individuals assert personal control of their lives; express opposition to adult authority and conventional society; deal with anxiety, frustration, inadequacy, and failure; gain admission to a peer group and demonstrate identification with a youth subculture; confirm personal identity; affirm maturity; and mark a developmental transition into young adulthood. Developmentally, risk-taking behavior serves an important function for adolescents. They are breaking away from the family to establish their independence and identity, to establish a support group outside of the family to which they want to "belong," and to establish "adult-like" behavior. Many would suggest that modern society provides few alternative ways for youth to establish their identity and maturity. Many rites of passage, evident in earlier societies, no longer exist. Others would argue that those who engage in excessive risk-taking behaviors do so because of personality systems characterized by lower value on academic achievement, higher value on independence, greater social criticism and alienation, lower self-esteem, orientation to an external source of control, greater attitudinal tolerance of deviance, and lesser religiosity. The researchers strongly suggest that there is a "psychosocial" readiness among some young people to engage in antisocial and excessive risk-taking behaviors. This does not mean that the adolescents are aiming for risk, but rather are choosing behaviors because of how the behaviors make them feel de thrilled, socially adequate, or stimulated. Young people, themselves, do not perceive many of these behaviors as "risky" or "antisocial." Start Prevention Early Even though there have been few studies that focus on childhood and pre-adolescent predictors of alcohol and other drug use, we do know that the age of initial use has been declining. For instance, by age 13, 30 percent of boys and 22 percent of girls classify themselves as "drinkers." A 1987 Weekly Reader survey showed that peer pressure can begin as early as fourth grade. This report found that while pressure to use marijuana had decreased from what it was in 1983, the level of peer pressure had remained unchanged for alcohol -- ranging from 36 percent of students 44 experiencing such peer pressure in fourth grade to 51 percent in sixth grade and 76 percent in grades seven and twelve. Children in kindergarten through sixth grade have been found to have greater expectations that they will use alcohol and other drugs if the adults in their families are users of illegal substances and cigarettes or abusers of alcohol and if these adults engage their children in "drug-taking behavior," which may include asking the children to light cigarettes, pour and serve alcoholic beverages, or get medicines. Another study of 133 families in New York found that parental characteristics measured during children's first three years could discriminate those children who later were using alcohol and other drugs at age 16 or older. Many studies have found that early involvement by youth in alcohol and other drug use increases the likelihood of future problems with alcohol and other drugs. One researcher who has followed youth over a long period of time found that early use of alcohol, for instance, represents a "watershed" crossed in relation to later involvement in a wide range of problematic behaviors. Others have found that those who exhibit antisocial behavior, e.g., excessive shyness or aggressiveness, in the early elementary ages should be targeted for prevention efforts even though approximately half of these children will not develop alcohol or other drug problems or engage in juvenile delinquent acts. Of these children, those who have alcohol-abusing or illegal-drug-using parents should be a primary target. Conversely, alcohol and other drug use in early adolescence is more frequently associated with antisocial acts. Early initiation also is linked to a higher risk for more extensive use of alcohol and other drugs. The earlier the onset of any drug use, the greater the involvement in other drug use and the greater the frequency of use. Early initiation into drug use increases the probability of extensive and persistent involvement in the use of drugs and the probability of involvement in deviant activities such as crime and selling drugs. As Erickson pointed out, prevention strategies that do begin early must be developmentally appropriate. Kids under the age of 12 think in concrete, as opposed to abstract, terms: If root beer doesn't contain beer and ginger ale doesn't contain ale, then why should wine coolers contain wine? It is important to communicate with children under age 12 in terms they understand and through agents with whom they feel comfortable. Most researchers conclude that since the "family" is the main socializing agent for children, families should be involved in childhood, pre-adolescent, and early adolescent prevention efforts. Establish and Sustain Non-Use Norms for Youth According to one researcher, permissive parental attitudes toward drug use as perceived by youth may be of equal or greater importance than actual parental drug use in determining much drug use by adolescents. A researcher studying the effectiveness of school-based programs found that once young people found out that "not everyone was smoking and that smoking was considered by peers to be unacceptable," a decrease in smoking behavior occurred. Conformity to peers is often considered one of the hallmarks of adolescent behavior. Early adolescents' need for affiliation with a group of peers is manifested by conformity to group norms, and the group itself is strengthened when members exert conformity pressures on each other. One study found that young people generally are less likely to be pressured into behavior they perceive as antisocial. The problem arises in the ambivalence of peers, communities, and society as a whole concerning what constitutes antisocial behavior: is alcohol and other drug use considered "normal" or antisocial, acceptable for youth or unacceptable for youth? Peer modeling and peer norms have significant effects on adolescent drinking, and adolescent drinking results in a higher probability of using other illegal drugs such as marijuana and cocaine. Several researchers have found that social influence is a matter of setting and enforcing standards for 45 conduct. Therefore, whether an adolescent uses alcohol or other drugs depends a great deal on whether drinking is approved and sanctioned by other people, including parents or guardians, peers, other role models, and the media. In general, the researchers suggest that parental norms about drinking and the drinking behaviors of peers are important predictors of use. These findings suggest that prevention efforts take the form of teaching parents to establish non-use norms and of making adolescents more aware of the fact that most young people do not use cigarettes, alcohol, or other drugs. In addition, researchers have found that the more pressure adolescents perceive from friends to engage in alcohol and other drug use, the more frequent is their self-reported involvement in these behaviors. Alternatively, the stronger the perceived pressures are against alcohol and other drug use, the more adolescents reportedly refrain from using these substances. The implication is that because of the bidirectional nature of peer pressure, peers are potentially prosocial influences -- thus the term, "positive peer pressure." Assess the Needs and Target the Efforts According to many researchers and clinicians, alcohol and other drug use by youth meets a wide range of needs that may have to be examined before launching a prevention or intervention program. Needs may be psychological or social and include the desire to anesthetize oneself from feelings associated with stressful life events; to assert one's maturity, masculinity, toughness, or individuality; to gain group acceptance and feelings of social adequacy or to avoid peer pressure; to compensate for lack of other skills; or to relax, relieve boredom, or celebrate. In some cultures, use of alcohol and other drugs are often used by young people to demonstrate a "higher" status, e.g., a scotch drinker versus a beer drinker. Many young people believe that use of alcohol and/or other drugs gives them a sense of control over their lives, especially in environments in which they have little control. Alcohol and other drugs also have been used throughout history as self-medication. Today's fourth, fifth, and sixth graders believe that the main reasons kids start to use drugs, including alcohol, are to fit in, feel older, have a good time, and avoid feeling bad. Understanding the expectations that young people hold about the function of alcohol and drug use will be helpful. For instance, researchers have found that young people who believe that their parents expect them to drink or use other drugs are more likely to do so. Youth who believe that drug-taking is expected behavior may, therefore, be at especially high risk. When explored with young people, the need to "fit in" is often translated as "since everyone is doing them, I want to also." Effective programs address the myth that everyone is using alcohol and other drugs, as well as other misconceptions. Once community leaders and young people understand the reasons why young people are using alcohol and other drugs, they can be brought together to discuss alternatives as part of a prevention strategy. When one group of high school students was asked to think of a different way to engage in risk-taking behavior, they suggested watching the movie "Jaws" in a crowded pool with their peers! Take a Broad, Environmental Approach Prevention activities operate in complex social and economic environments in which many variables interact with each other over time. When variables are studied in isolation, it becomes difficult to explore the precise linkage between action and effect, or to assess the impact of concurrently operating prevention efforts. We know that a variety of factors influence the consumption of alcohol and other drugs by youth and adults alike. These include genetic and biological predisposition; family practices, attitudes, and norms; socialization patterns, peer behaviors, and contacts; community practices (including early use patterns) and norms, as well as the price of alcohol and other drugs; the economic and educational levels of the community; exposure to media and other messages that encourage use; laws about use (such as the legal drinking age or sanctions for use of illegal drugs set 46 by states); policies determining the availability of substances; and policies and practices that encourage and reward help-seeking behaviors. Consumption by youth also is influenced by role modeling of older siblings, parents, doctors, actors, rock stars, and others. Although incomplete, the preceding list points to the need for integrated programs with enduring, coordinated, and persuasive strategies that address the many domains of environmental influence on youth and their older role models. Single-target prevention approaches are not successful and cannot possibly compete with the daily contact young people have with many different people, télevision, music, and reading materials. It is the daily contact through which young people develop their lifestyles and the context in which alcohol and other drug use must be examined. Prevention efforts in the past have placed the greater emphasis on personalized motives and causes for alcohol and other drug use and as a result have often lost sight of the larger environmental determinants of use. That is, alcohol and drug use among youth is frequently labeled as an individual problem instead of as a social problem. However, when one begins to readdress use as a social problem, solutions take a different shape. For instance, teaching how to "Just Say No" may be even more effective if directed at communities instead of individuals. Families, schools, churches and synagogues, scout troops, boys' and girls' clubs, housing projects, chambers of commerce, and entire communities can make a commitment to "saying no" and to promoting health, safety, and meaningful lifestyles. As discussed in the models and theories, these efforts must increase awareness; change attitudes; develop skills; provide training and alternatives; allow for trial, adoption, and practice of new behaviors with support from family, friends, classmates, coworkers, and the community; and continually reinforce healthy lifestyles-- whether new or brought forward from childhood. Entire communities can gather information about the problem as it appears in their community, make a commitment to supporting a drug-free community, set goals and objectives, identify resources, and plan rewards and celebrations for meeting their goals. The importance of a well-rounded approach to prevention cannot be overemphasized; a problem attacked from many directions has a better chance of being solved than does a problem addressed from a single-solution orientation. 47 NEEDS ASSESSMENT Before planning a prevention effort, a good deal of information is needed. This information includes the level of alcohol and other drug problems in the community and existing prevention and intervention programs. Assessment involves judging or determining the importance, size, or value of something. If you find that an alcohol or drug problem does exist in your community - and most communities will -- it is important to take an in-depth look at your community and make some judgments and decisions about how to proceed with your prevention efforts. Needs assessment can help uncover concerns of highest priority. It can also help to define objectives, which may help uncover concerns of highest government priority. The objectives should be established within the framework of overall goals. The common goal of prevention and intervention efforts is to reduce the incidence of alcohol- and other drug-related problems. Prevention measures are addressed to large populations, including those who may not yet drink or take other drugs. Intervention strategies are targeted to more discrete groups of individuals: those who consume alcoholic beverages either heavily, frequently, or under conditions that endanger health, life, or property; those who abuse prescription or over-the-counter drugs either alone or in combination with other drugs, including alcohol; and those who use illegal drugs, including underage youth who use alcohol. The specific goal of intervention is to help these people obtain early treatment or to modify their behavior to eliminate or minimize the risk of developing further problems. The specific goal of prevention programs, on the other hand, is to prevent problems before any symptoms have occurred. Interpretation and emphasis often determine whether a particular measure is defined as prevention or as intervention. Questions you might ask to assess the needs of your community include: 1. What do community members know about alcohol and drugs? What are their attitudes toward these substances? How many people use them and how much do they use? Breaking these data out by age, sex, ethnicity, income, and other demographic characteristics of respondents provides a clearer picture of the community. 49 2. Where, when, and with whom do community members use alcohol and other drugs? In other words, what is the context of use? Sometimes aiming a prevention effort at the context of a problem is more effective than aiming it at individual users. 3. Which high-risk factors for use of alcohol and drugs by youth, and for abuse by adults, are relevant to your community members? For instance, it may be important to ascertain the family norms, consumption patterns, and attitudes of different peer groups, as well as the community attitudes concerning the use of alcohol and other drugs by minors. 4. Is there a significant population, such as children of alcoholics or illegal drug users, that may require more intensive efforts? 5. What and who are the credible and respected sources of information in your community? Answers to many of these questions are sometimes attainable from state departments of health, alcohol and drug abuse, mental health, education, and transportation. University consultants from a variety of disciplines and private research companies often supply information as well. Further information on conducting a needs assessment can be obtained from the National Clearinghouse for Alcohol and Drug Information at (301) 468-2600. 50 CONCLUSIONS Public opinion polls and other measures show that adults and young people alike are aware of the seriousness of the alcohol and drug problem in this country. Having raised the public's consciousness to these issues, prevention can now move forward. One thing that appears certain is that the causes of alcohol and other drug use are complex. For that reason, confronting the problem from a single direction is not likely to be effective. Community members and groups need to work together to make a difference and to form a united voice against alcohol and drug use by their youth. More than thirty five national voluntary and professional associations representing approximately 30 million people have made a commitment to preventing alcohol and other drug problems among the nation's youth. These efforts can be enhanced by state and local governments. States and localities need to be involved in community needs assessment. Development of mutual common strategies will complement the efforts of community members and groups. The support of multiple governmental agencies, particularly educational institutions, will be required. And finally, the focus on community prevention efforts may require the reallocation of state and local resources toward this end. Resources Health Education Quarterly, Volume 12, Number 2, Summer 1985. Journal of Children in Contemporary Society, Volume 18, Number 1 and 2, Fall/Winter 1985. Journal of School Health, Volume 56, Number 9, November 1986. National Institute on Alcohol Abuse and Alcoholism. Sixth Special Report to the U.S. Congress on Alcoholism and Health, January 1987. National Institute on Drug Abuse. Preventing Adolescent Drug Abuse: Intervention Strategies, Research Monograph #47, 1983. Preventive Medicine, An International Journal Devoted to Practice and Theory, Volume 15, No. 5, September 1986. 51 PART THREE: Alcohol and Drug Abuse Prevention Programs in the States 53 INTRODUCTION The task force chair, Governor Martha Layne Collins, sent a survey letter to each Governor requesting information on state drug strategies, effective state initiatives in alcohol and drug abuse prevention, and the name of the state program coordinator for substance abuse programs. Information was received from many states. Information on substance abuse programs in states that did not respond to the survey letter was collected from several reports, including the 1984 Task Force on Substance Abuse Prevention report by the National Conference of Lieutenant Governors. This report involves an extensive review of state and local programs. Information also was provided by the National Association of State Alcohol and Drug Abuse Directors (NASADAD). A 1985 study that NASADAD conducted for the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, "An Analysis of State Alcohol and Drug Abuse Profile Data," was very helpful. 55 SUMMARY OF ALCOHOL AND DRUG ABUSE PROGRAMS IN THE STATES Alabama The Alabama Department of Mental Health acts as the sole funding and rulemaking authority for programs in the state. Its prevention section works with local volunteer and private, non-profit programs to provide a variety of activities. The prevention section is the primary state agency working with alcohol and drug education programs in the schools. There are a total of thirty-one programs statewide that have prevention activities. The majority of programs on the local level are run by community mental health centers. In addition to developing school curricula, the state prevention section has worked with the Office of Highway and Traffic Safety to provide information to junior and senior high classes. The department also has initiated alcohol projects on college campuses along with the state's Alcohol Beverage Control Board. The prevention section also works with parent/teacher groups, establishing a statewide parents' consortium. There are also programs for the elderly and specialized workshops for professional groups. For more information, contact: Division of Mental Illness and Substance Abuse Community Programs 200 Interstate Park Drive, Box 3710 Montgomery, Alabama 36193 Mary Lee Rice, Director (205) 271-9253 Alaska State law mandates that programs funded by the State Office of Alcoholism and Drug Abuse (SOADA) receive grants-in-aid. SOADA-funded grant recipients are required to demonstrate that local planning and input have gone into the development of the program. A local policy or advisory board is required for all projects. Community program grants require a minimum of 10 percent in financial match in order to receive state funds. With many local programs, the required match is 50 percent or more. Programs are held accountable through annual on-site evaluations and biannual fiscal audits. For more information, contact: 57 State Office of Alcoholism and Drug Abuse Department of Health and Social Services Post Office Box H-05-F Juneau, Alaska 99811-0607 Matthew Felix, Coordinator (907) 586-6201 Arizona Drug and alcohol abuse programs in the state are funded and supervised by separate sections under the state Department of Health Services. Local programs are required to provide matching funds for state contracts. Programs are funded according to the priority populations of children and adolescents, women, parents and families, minorities, and the elderly. Department funds support five types of prevention programming: education and training, media, community development, alternatives, and program consultation. Each local recipient of funds provides a variety of programs aimed at specific target groups. Programs are required to perform process and outcome evaluations, using individualized evaluation designs. For more information, contact: Alcohol Abuse Section Division of Behavioral Health 701 East Jefferson Suite 400A Phoenix, Arizona 80534 Michael Schwegler (602) 255-1152 Arkansas The Governor of Arkansas recently announced the establishment of a Professorship on Alcohol and Drug Abuse Prevention and an endowed Chair on Alcoholism and Drug Abuse Studies at the University of Arkansas for Medical Sciences. The professorship is in the College of Pharmacy and was made possible through a grant from the Arkansas Department of Human Services' Alcohol and Drug Abuse Prevention (OADAP) division. The endowed chair will be in the College of Medicine and was made possible through a challenge grant from OADAP. Other funds for this Chair will be raised from a temporary, legislatively imposed alcohol beverage tax. In addition, OADAP funds and supervises school and community-based programs in the areas of primary prevention and education of drug and alcohol abuse. Efforts are made to involve youth in all project planning and implementation. All programs are encouraged to recruit volunteers, and community participation is heavily weighed when programs are selected for funding. For more information, contact: Office on Alcohol and Drug Prevention 1515 West 7th Street, Suite 310 Little Rock, Arkansas 72202 Paul T. Behnke, Director (501) 371-2604 California The state's Department of Alcohol and Drug Programs is divided into alcohol and drug divisions. Most of the federal and state dollars for prevention are distributed to the state's fifty-eight counties, which in turn administer and fund local programs. 58 Both divisions are involved in prevention activities as well. The department as a whole coordinates a statewide parent/community prevention effort, including networking, parent training, information dissemination, and media campaigns. The department is also responsible for monitoring county-operated school and community-based projects. There are 636 programs in the state of California that provide some type of drug abuse and/or alcoholism prevention services. They range from treatment facilities to school-based groups to community groups. For more information, contact: Division of Alcohol Programs 111 Capitol Mall Sacramento, California 95814 Susan B. Blacksher, Chief Colorado The Alcohol and Drug Abuse Division of the Colorado Department of Health is the funding authority for prevention programs in the state. It has developed a statewide service delivery system offering many strategies directed at such target populations as high-risk youth, ethnic minorities, and women. There are school programs, community-based projects, and worksite programs, providing various degrees of information, education, intervention, and alternatives. For more information, contact: Communities for a Drug-Free Colorado 136 State Capitol Denver, Colorado 80203 Julie Fagan, Project Director (303) 866-2885 Connecticut The Alcohol and Drug Abuse Commission, a free-standing state agency, is responsible for funding and overseeing programs in the state. Funds are distributed on a statewide basis. Drug and alcohol education is mandated, but there are no specifications for curricula. For more information, contact: Alcohol and Drug Commission 999 Asylum Avenue Hartford, Connecticut 06105 Donald J. McConnell, Executive Director (203) 566-4145 Delaware The Bureau of Alcoholism and Drug Abuse, part of the Department of Health and Social Services' Division of Mental Health, funds and oversees programs. The state's primary prevention contractor, the Resource Center, is charged with providing assistance to and networking activities of the state's parent groups and SADD chapters. There are more than thirty-five parent groups and fifteen SADD chapters in Delaware. In addition, some schools use the "Here's Looking at You Two" K-12 curriculum. For more information, contact: 59 Bureau of Alcoholism and Drug Abuse Connecticut Building, 2nd Floor 1901 North DuPont Highway New Castle, Delaware 19720 Sara Taylor Allshouse, Bureau Chief (302) 421-6101 Florida The state authority oversees funding and program requirements for prevention efforts in Florida. A full range of programs can be found, ranging from parents groups to school-based substance abuse prevention programs. Founded in 1979, the Florida Informed Parents organization is composed of eighty-six parent groups, with membership totalling about 10,000. Focusing on school-age drug use, the organization provides workshops, conferences, and parent peer groups. The Florida State Cabinet has commended the organization for its work in coordinating the Chemical People program in Florida. Florida Informed Parents demonstrates the unique value of the parent movement, coordinating law enforcement, schools, churches, and civic groups in working toward a common goal of drug-free youth. The group's philosophy is that a community must work together to establish a policy that drug use is not acceptable for its young people, and that policy must be clearly communicated to the youth. For more information, contact: Alcohol and Drug Abuse Program 1317 Winewood Boulevard Tallahassee, Florida 32301 Linda Lewis, Administrator (904) 488-0900 Georgia The Department of Human Resources is the sole funding authority for drug and alcohol abuse programs. The department distributes federal block grant dollars to local mental health agencies. The Alcohol and Drug Services Section provides technical assistance to local programs. In addition, the Prevention Unit of the Division of Mental Health and Mental Retardation has developed a program for school-age children. Life Skills for Mental Health teaches youth problem- solving skills and ways to handle pressure to use drugs. Twenty-six community mental health centers across the state have teams trained to conduct workshops and follow-up for teachers, and other youth workers to learn to use the program. For more information, contact: Alcohol and Drug Services Section 878 Peach Street, Northeast Suite 319 Atlanta, Georgia 30309 Patricia Redmond (404) 894-4785 Hawaii The Alcohol and Drug Abuse Branch of the Department of Health is the single state authority for funding. Part of the Division of Mental Health, the branch works with the Office of Primary Prevention to review program proposals and to monitor existing programs. 60 Funds for prevention programs are distributed on a statewide basis to private contractors. The state branch does program planning, development, and coordination. Alcohol and drug education is not mandated, but some schools use a K-12 curriculum through the state Department of Education. There are also seventeen Chemical People task forces throughout the state. For more information, contact: Alcohol and Drug Abuse Branch Honolulu, Hawaii 96801 Joyce Ingram-Chin, Branch Chief (808) 548-4280 Idaho The Substance Abuse Section of the Department of Health and Welfare directly funds the three programs. The programs' main focus is on reducing the incidence of alcohol and substance abuse problems in youth. The remainder of the state's programs are funded and administered on the county level. For more information, contact: Bureau of Substance Abuse Department of Health and Welfare 450 West State Street Boise, Idaho 83720 Ray Winterowd, Chief (208) 334-5935 Illinois Drug and alcohol programs currently are administered by separate agencies in the state government. The two oversee funding and set standards and operate out of regional offices. Programs are operated at the local level by various local government entities and private, non-profit agencies. Illinois has a strong community-based system of programs, which include agencies, teen peer leadership groups, and parent groups. Standard treatment programs are supported by stringent DUI laws, a narcotics trafficking confiscation law, and treatment alternatives to incarceration. As a result of the "Chemical People" project, at least ninety-six community task forces have been formed, bringing the state total of community and parent organizations to about 180. For more information, contact: Illinois Alcoholism and Drug Dependence Association 628 East Adams Suite 204 Springfield, Illinois 62701 James Long (217) 528-7335 Indiana The Division of Addiction Services of the Department of Mental Health directly funds local prevention programming through requests for proposals. Local programs. must be incorporated and can be profit or non-profit. Program efforts are coordinated by the state on a regional basis. 61 The division, in conjunction with the state Department of Public Instruction, has developed a curriculum guide for drug and alcohol education. Such education is mandated at the elementary level and is offered as anelective at the secondary level. For more information, contact: Division of Addiction Services 117 East Washington Street Indianapolis, Indiana 46204-3647 Joseph E. Mills III Iowa The Governor of Iowa has established the "Governor's Alliance on Drug Abuse" with a three- point comprehensive program including drug education, treatment, and prevention; tougher penalties for drug pushers; and stronger enforcement of drug laws. In October 1986, eight correctional facilities were opened for individuals convicted of operating a motor vehicle while intoxicated. These facilities offer a combination of treatment, supervised living, and employment opportunities. For more information, contact: Iowa Department of Public Health Lucas State Office Building Des Moines, Iowa 50319 Mary Ellis, Director (515) 281-5605 Kansas Programs are funded by a single state agency, the Department of Social and Rehabilitation Services/Alcohol and Drug Abuse Services. The prevention division offers program development for community-based programs and agencies, school programs, technical assistance, training and staff development for parent support groups, and family health promotion. The agency also offers employee assistance programs and conducts public information campaigns. While not advocating a particular model curriculum, the state does use the School Team approach developed by the U.S. Department of Education, including "teaming the athletic peer group." The state agency also coordinates Students Against Driving Drunk chapters. For more information, contact: Alcohol and Drug Abuse Services Biddle Building, Topeka State Hospital 2700 West 6th Street Topeka, Kansas 66606 Commissioner (913) 296-3925 Kentucky "Champions Against Drugs," the prevention initiative of the Kentucky Governor, is a public education and community mobilization campaign. The public education portion utilizes Kentucky sports figures and other well-known individuals to speak out against alcohol and drug abuse and to encourage citizens to become involved in prevention programs. Statewide, seventeen regional action groups currently are working to develop comprehensive strategies to address alcohol and drug problems at the state, regional, and community levels. The four-pronged approach to comprehensive programming includes public awareness, education and training (with a special emphasis on youth leadership training), intervention and treatment, and law enforcement. The program emphasizes collaboration at the state and community levels to build on and expand existing 62 service networks. The law enforcement component will conduct sixteen public hearings across the state and prepare recommendations and a legislative packet to present to state legislators during the 1987 session. There are more than sixty communities in Kentucky that have active citizen groups supporting programs to prevent the spread of drug problems, and there are at least fifty "Just Say No" clubs promoting drug-free activities and positive peer pressure for youth. For more information, contact: Division of Substance Abuse 275 East Main Street 1st Floor, East Wing Frankfort, Kentucky 40621 Michael Townsend, Director (502) 564-2880 Louisiana The Department of Health and Human Resources' Office of Prevention and Recovery from Alcohol and Drug Abuse provides alcohol and drug abuse prevention and treatment services through a number of facilities and programs, including: promotion and participation in major statewide substance abuse prevention campaigns, including Substance Abuse Awareness Week, Drunk and Drugged Driving Awareness Week, Be Smart Don't Start, Fetal Alcohol Syndrome Awareness Week, and Operation Prom/Graduation. six halfway houses for individuals recovering from substance abuse. six community-based outpatient treatment programs for drug and alcohol abuse funded through contracts. One of these programs (in Lake Charles, Louisiana) serves primarily adolescents and provides extensive prevention and early intervention services. four inpatient treatment facilities. Two of these facilities (one in Shreveport and one in Lake Charles) also provide detoxification services. twenty-four state-operated outpatient treatment clinics located throughout the state. Clinics provide substance abuse treatment, prevention, and early intervention services. For more information, contact: Office of Prevention and Recovery from Alcohol and Drug Abuse 2744 B Wooddale Boulevard Baton Rouge, Louisiana 70805 Rupert Richardson (504) 922-0721 Maine The Office of Alcoholism and Drug Abuse Prevention coordinates efforts in the state. In addition, three other state agencies are involved in prevention activities. The Maine Alcohol and Drug Abuse Clearinghouse is a function of the Department of Human Services' Bureau of Health, Division of Health Education. It serves as a central source for information about alcohol and other drugs, substance abuse prevention, treatment, research, and education. The clearinghouse also provides technical assistance and consultation in prevention program development. For more information, contact: 63 Division of Alcohol and Drug Education Services Stevens School Complex State House, Station 57 Augusta, Maine 04333 Carl D. Mowatt, Director (207) 289-3876 Maryland Programming in the state is funded and supervised by separate sections within the Department of Health and Mental Hygiene. In addition to the programs listed in this section, there are a number of Chemical People task forces, many SADD chapters, and "Tough Love" groups. The Alcohol and Drug Abuse Prevention Program also funds an additional twenty-six community development prevention programs statewide. Activities range from school-based prevention, peer leadership, parent education, and grass-roots networking. Regional coordinators cover the state to plan, coordinate, and advocate local services. The state office operates a direct elementary school- based effort, the "Kool Pat -- Little Moe" decisionmaking program. For more information, contact: Alcoholism Control Administration 201 West Preston Street, 4th Floor Baltimore, Maryland 21201 Darlind Davis, Assistant Director (301) 225-6555 Massachusetts The Governor of Massachusetts created the "Governor's Alliance Against Drugs" in December 1984. The program is a coordinated statewide effort that has mobilized communities to confront the issue of student drug and alcohol abuse. In its first year, the alliance enlisted the support of more than 200 Massachusetts communities in an effort to combat substance abuse among young people. The program entails counseling services for youth and their families, teacher training/program development, regional primary prevention centers, youth residential treatment, and identification of high-risk youths. For more information, contact: Governor's Alliance Against Drugs 1 Ashburton Place, Room 2131 Boston, Massachusetts 02108 Marianne Lee, Deputy Director Drug Program Coordinator Michigan The major prevention licensing category is called CAIT, reflecting the state's priorities of community change, alternatives, information, and training. Licensed programs include private, state, and locally supported efforts. The types of services offered range from community-based information activities to school-based education programs and Alcohol Highway Safety Education services. Michigan recently completed a five-year prevention plan, developed at the state-level with input from local programs and communities through the state Prevention Advisory Council. The plan focuses on state and local efforts in six major "core" services, including preschool education, school health curriculum, parent/teacher peer training, community-based prevention services, mass media influence, and employee health promotion. 64 Current state policy requires that any new state funding allocated to prevention be utilized for the improvement or development of the services described in the plan. For more information, contact: Office of Substance Abuse Services 3423 North Logan Street Lansing, Michigan 48909 Robert Brook, Administrator (517) 373-8603 Minnesota The Chemical Dependency Program Division of the Department of Human Services is the single state authority for drug and alcohol programs. The office administers federal block grants and state funds. While some programs must participate in the proposal request process yearly, the office also funds long-term projects on a three-year basis. There are many programs for the state's sizeable Native American population, for which there is a citizens' advisory board. The state office is currently working on special projects for Spanish- speaking citizens. While the Chemical Dependency Program Division does not license, it does provide technical assistance to local programs. It has established the Minnesota Prevention Resource Center to work with local programs, including providing "seed" money for new projects. There are about 415 chemical abuse prevention task forces in Minnesota. Minnesota has an extensive school drug/alcohol. education program, which is supervised by the state Department of Education. Alcohol and drug education is mandated, and the state reimburses school districts for their programs. Many schools work with the Prevention Resource Center on program development. For more information, contact: Chemical Dependency Program Division 444 Lafayette Road St. Paul, Minnesota 55155 Cynthia Turnure, Director (612) 296-4610 Mississippi The Division of Alcohol and Drug Abuse of the Department of Mental Health funds programs throughout the state on a regional basis. The programs include community mental health centers, free-standing programs, state hospitals, and state universities. The division also supports an in- house clearinghouse with written materials and a film library. Specialized prevention activities also are planned at the state level. For more information, contact: Division of Alcohol and Drug Abuse. 1500 Woolfolk Building Jackson, Mississippi 39201 Anne D. Robertson, Director (601) 359-1297 Missouri The Governor recently announced a six-part drug and alcohol abuse initiative designed to forge a partnership between state and local groups toward preventing drug and alcohol abuse. The plan, 65 called "MO say NO to Alcohol and Drug Abuse," provides a coordinated response to the problem of substance abuse in the state. Among the initiative's goals are creating local responses to local problems by forging a partnership between schools and community groups; teaching students about the dangers of alcohol and drug abuse by improving the alcohol and drug abuse curriculum; and identifying and treating young people with drug problems through early intervention efforts. The initiative is the work of a team of state government experts in the areas of health, public safety, schools, mental health, and youth. For more information, contact: Division of Alcoholism and Drug Abuse Department of Mental Health 1915 South Ridge Drive Jefferson City, Missouri 65102 Lois Olson, Director (314) 751-4942 Montana Programs in the state are funded and supervised by the Alcohol and Drug Abuse Division of the Department of Institutions. The state is divided into five regions. Every outpatient chemical dependency program provides some type of prevention and/or early intervention activity on an on- going basis. An on-going program brings parents and teenagers together in both peer groups and family units. Three areas of discussion deal with drinking and driving, alcohol and drug use, and their effects. Parents and teens focus on solving problems, expressing feelings, making decisions, and communicating. A structured group therapy experience for first offense adolescent drug and alcohol abusers uses peer relationships to aid them in changing their lifestyles. The program is intended to be an alternative to suspension/expulsion or incarceration. Consisting of eight two-hour sessions over an eight-week period, the groups work on heightening self-esteem, improving communication skills, fostering interpersonal relationships, and aiding members in setting personal goals. For more information, contact: Alcohol and Drug Abuse Division 1539 11th Avenue Helena, Montana 59624 Bob Anderson, Administrator (406) 444-3904 Nebraska The Division on Alcoholism and Drug Abuse of the Department of Public Institutions is the single state funding authority for prevention programs. The division was created when two separate commissions were consolidated by legislative mandate several years ago. The division funds only prevention programs; regional governing boards fund only treatment programs. Alcohol and drug education is mandated, but the state's school districts may implement it as they choose. The division has worked with the state Department of Education to develop a curriculum, "Decisions About Alcohol and Other Drugs," which is available to state schools. In addition, the state authority has produced a videotape, "Resisting Pressures to Drink and Drive." For more information, contact: 66 Division on Alcoholism and Drug Abuse P.O. Box 94728 Lincoln, Nebraska 68509-4728 Cecilia Doughty Willis, Director (402) 471-2851 Nevada Programs are funded and supervised by the Bureau of Alcohol and Drug Abuse of the Department of Human Resources. The bureau also has set up tutoring programs on Indian reservations and in juvenile probation centers. It distributes a newsletter, the "Alcothon," has organized Families Anonymous and Tough Love groups, has a resource library, and provides technical assistance to local programs. The bureau provides training and curriculum materials to the state's public and private schools, including the "Starting Early" and "Alcohol Awareness" programs for junior and senior high schools and the "Positive Action" program. There are also twelve Chemical People task forces located throughout the state. For more information, contact: Bureau of Alcohol and Drug Abuse 505 East King Street, Room 500 Carson City, Nevada 89710 Richard Ham, Chief (702) 885-4790 New Hampshire Substance abuse programs are divided between treatment and intervention programs. For those who are at risk to develop a potentially serious substance abuse problem, intervention programs are appropriate. When the individual and/or family is directly affected by substance abuse or addiction, treatment services are involved. The state. owns and operates a halfway house for recovering male alcoholics. Other services are provided through contracts with non-profit agencies and organizations. Public funding supports outpatient counseling at twenty-one separate locations throughout the state, two twenty- eight-day residential programs for the treatment of alcoholism, beds purchased in two therapeutic communities that treat the multi-problem substance abuser, funding of seven crisis intervention centers developed to care for the publicly inebriated, and financial support for one halfway house for women. Seven Crisis Intervention sites are located in the state. The primary audience of these sites are individuals who are suffering intoxification from alcohol and who are not in a medical emergency. The staff is composed of volunteers who are specifically training in the management of the inebriate and Emergency Medical Technicians. For more information, contact: Office of Alcohol and Drug Abuse Prevention Health and Human Services Building #6 Hazen Drive Concord, New Hampshire 03301-6525 Geraldine Sylvester, Director (603) 271-4627 67 New Jersey The Governor of New Jersey is calling for the creation of an "Alliance for a Drug Free New Jersey." The alliance calls for business, law enforcement, religious, education, and community leaders to establish a statewide program against substance abuse. It plans to solicit New Jersey's 567 cities and towns in an effort to abolish drug abuse. The aims of the alliance include: organizing and coordinating the efforts of school, police, business groups, and other community organization to fight drug abuse; adopting a K through 12 drug abuse education program in the schools that have been determined to be comprehensive and effective; adopting clear procedures for the intervention, treatment, and discipline of students abusing alcohol and drugs; providing a comprehensive drug abuse education and outreach program for parents; and providing a comprehensive substance abuse community awareness program. The program focuses heavily on the demand side and seeks to make sure that every child in the New Jersey public school system receives drug abuse education. The primary strategies focus on prevention, intervention, and treatment. Prevention programs are geared toward limiting the demand for drugs through increased public awareness, community activity, and parental support. Intervention programs seek to identify drug abusers at the earliest point and encourage their participation in appropriate treatment programs. For more information, contact: Division of Alcoholism Department of Health 129 East Hanover Street Trenton, New Jersey 08625 Riley W. Regan, Director (609) 292-8949 Division of Narcotic/Drug Abuse Control 129 East Hanover Street Trenton, New Jersey 08625 Richard J. Russo, Director (609) 292-5760 New Mexico Programs in the state are funded and supervised by the Behavioral Health Services Division of the Health and Environment Department There is a heavy emphasis on community involvement, particularly for youth and the elderly. Many community agencies sponsor an alternative prevention education drop-in center for youth ages 6 to 19. In addition, there are programs for the elderly. Several Native American groups have specialized programs for their members. For more information, contact: Drug Abuse Bureau P.O. Box 968 Santa Fe, New Mexico 87504 Ron Coss, Acting Chief 68 Alcoholism Bureau P.O. Box 968 Santa Fe, New Mexico 87504 Arturo Rangel, Chief (505) 827-2587 New York Programs in the state are funded and overseen by the Division of Substance Abuse Services of the Office of Alcoholism and Substance Abuse. Prevention programs are funded through the counties, which then sub-contract to non-profit community-based and school-based agencies. Funding is provided for about 146 prevention programs, with assistance to another fifty-six community groups. There are also county councils on alcoholism that provide information and referral services as well as prevention and education programming. In addition, there are programs that receive state and local funding under a local assistance formula, and that do not report to the division. The division centrally operates a Fetal Alcohol Syndrome/Alcohol Related Birth Defects prevention and education program as well as statewide information and awareness campaigns. For more information, contact: Division of Alcoholism and Alcohol Abuse 194 Washington Avenue Albany, New York 12210 Robert V. Shear, Director (518) 474-5417 North Carolina The Governor has created the Governor's Council on Alcohol and Drug Abuse Among Children and Youth to bring to the state a new awareness of this problem. The council is charged with reviewing and making recommendations to the Governor on youth substance abuse issues. It reviews and recommends mechanisms for coordination of state and local resources; conducts public hearings; promotes local boards, councils, or commissions to identify model prevention, intervention, and treatment efforts for possible statewide replication; and conducts public awareness activities. The Governor challenged every local community to form a local task force or coalition on substance abuse. A statewide conference will be held in the fall for local officials, law enforcement personnel, business leaders, education officials, health organizations, and civic leaders to share information and build a solid foundation for addressing the drug problem. At the forum, a booklet with information on every anti-drug effort at the state level will be released. The Office of Alcohol and Drug Services, of the Department of Human Resources' Division of Mental Health, Mental Retardation, and Substance Abuse Services is the single state agency for drug and alcohol programs. Prevention programming on the local level is carried out by area mental health agencies, which either provide direct services or contract with private, non-profit agencies. Drug and alcohol education is mandated in state schools. The Office of Alcohol and Drug Services works cooperatively with the state Department of Education to implement curricula. For more information, contact: 69 Alcohol and Drug Abuse Services Division of Mental Health, Mental Retardation and Substance Abuse Services 325 North Salisbury Street Raleigh, North Carolina 27611 Tom Miriello, Deputy Director (919) 733-4670 Nort" Dakota The Division of Alcoholism and Drug Abuse of the Department of Human Services funds and supervises programs in the state. The state is divided into regions for program administration. Activities sponsored by the division include media campaigns focused on youth and responsible adult drinking, with special campaigns around the holidays offering alternatives to alcoholic beverages and responsible drinking and driving. Youth media campaigns and educational programs focus on peer group resistance and individual responsibility. In addition, the division provides curriculum guides, speakers, and information resources. For more information, contact: Division of Alcoholism and Drug Abuse State Capitol, Judicial Wing Bismarck, North Dakota 58505 John J. Allen, Director (701) 224-2769 Ohio Alcohol and drug abuse programming in the state is overseen by two authorities. The Bureau of Alcohol Abuse and Alcoholism Recovery awards state and federal funds, coordinates programs, and sets standards. It also funds the state's alcoholism counselors certification program and sponsors the annual Teenage Institute for the prevention of alcohol and other drug abuse. The Bureau of Drug Abuse provides similar supervision and support for drug programs. Planning, implementation, and coordination of alcoholism programs on the local level is done by twelve regional councils, made up of citizens from each region. For more information, contact: Department of Mental Health Office of Education and Training 30 East Broad Street, 13th Floor Columbus, Ohio 43215 (614) 466-9902 Oklahoma The state Department of Mental Health is the single state authority funding and overseeing drug and alcohol abuse programs. The department is divided into divisions for the administration of programs. Prevention programming is funded on the basis of statewide pilot demonstration projects that must submit competitive bids. Drug and alcohol education is not mandated in the state, and no one curriculum is endorsed. For more information, contact: 70 Alcohol and Drug Programs P.O. Box 53277, Capitol Station Oklahoma City, Oklahoma 73152 Tom Stanitis, Director (405) 521-0044 Oregon Prevention services in the state are funded and supervised by the Office of Programs for Alcohol and Drug Problems, Division of Mental Health, Department of Human Resources. Rules and guidelines are established by the state. Management of services is done jointly between state and county governments. State funding guidelines recommend that programs be targeted toward elderly, adolescents, children of alcohol and drug abusers, and women. Programs at the local level include student assistance, peer counseling, and school prevention curriculum. There are also DUI education and treatment programs, media campaigns, prescription drug abuse prevention efforts, employee assistance programs, Channel One projects, and facilitation of parent groups to fight drug abuse. For more information, contact: Programs for Alcohol and Drug Problems 301 Public Service Building Salem, Oregon 97310 Jeffrey N. Kushner, Assistant Director (503) 378-2163 Pennsylvania The Drug and Alcohol System was primarily a treatment-based system until 1980. With the onset of the federal block grants, Pennsylvania was required to spend 20 percent of all federal funds on prevention or early intervention services. In addition, the Office of Drug and Alcohol Programs (ODAP) established a policy that required at least 10 percent of all state monies to be used for prevention services. With a $42 million appropriation, ODAP spends approximately $4.2 million on prevention and early intervention services. The majority of the $4.2 million is allocated to the Single County Authorities or county agencies to develop and implement prevention/intervention programs that meet the needs of Pennsylvania's diverse population. However, ODAP retains some of these funds to enable it to develop and implement special statewide initiatives such as Teen Pregnancy, Underage Drinking and Driving Programs, and Student Assistance Programs. In addition, interagency contracts have been established and continued with the Departments of Education, Corrections, and Public Welfare to develop and implement programs for school-age children and criminal justice clients. The office also has obtained grants from the Pennsylvania Commission on Crime and Delinquency and the Department of Transportation to support efforts for juvenile offenders with drug and alcohol problems, and for Driving While Under the Influence offenders. For more information, contact: Office of Drug and Alcohol Programs P.O. Box 90 Harrisburg, Pennsylvania 17108 Jeannien Peterson, Deputy Secretary (717) 787-9857 71 Rhode Island The Division of Substance Abuse of the Department of Mental Health, Retardation, and Hospitals is the single state authority for funding and supervision of prevention programs. The division funds local private, non-profit contractors on an annual basis and provides training services, community assistance, and information materials There are also seventeen parent groups, many having grown out of the Chemical People program. The Division of Alcohol and Drug Abuse is the single state funding authority. It funds and oversees three regional resource centers, which coordinate local efforts. The division also directly funds some local programs. It has targeted school curriculum development, working with state schools to implement alcohol and drug education. The division also contracts with local treatment facilities that provide some prevention information. For more information, contact: Division of Substance Abuse Substance Abuse Administration Building Cranston, Rhode Island 02920 William Pimentel, Assistant Director (401) 464-2091 South Carolina The South Carolina Commission on Alcohol and Drug Abuse provides funding and technical support for the state's prevention programming. On the local level, programs are administered by county commissions of alcohol and drug abuse. The state has developed several model programs that are used locally. These include the School Intervention Program which began in 1978. The program involves local commissions and school districts in an effort to reduce alcohol and drug abuse and/or anti-social behaviors among students in grades 7 to 12. Other programs include the Counseling and Referral Elective, a type of employee assistance program, and the Alcohol/Drug Safety Action Program, an intervention system designed to reach the drinking driver and the minor drug offender with educational and counseling rehabilitation. Under the program, a first-offense DUI violator may receive a provisional license, and contingent upon successful completion of the drug program, an offender may be eligible for expungement of his or her arrest record. The commission also has established the Addictions Coordinators Network, which includes nine primary prevention services projects, two prevention volunteers projects, and four community-based prevention projects. For more information, contact: Commission on Alcohol/Drug Abuse 3700 Forest Drive Columbia, South Carolina 29204 William J. McCord, Director (803) 734-9520 South Dakota The state addresses alcohol and drug abuse problems through the assignment of responsibilities to those state agencies that have the appropriate jurisdiction and expertise. The agency most directly responsible takes the initiative. When areas overlap and involve a number of agencies, coordination of roles takes place among involved state, local, and federal agencies. 72 According to South Dakota law, mandatory posting of warnings in all places selling alcoholic beverages must advise the dangers of drinking alcohol while pregnant or nursing a baby. These are- several programs for substance abuse prevention in the state; among them is "Solutions," which is composed of teenagers who use theater and group discussion to help young people and adults deal with problems that involve alcohol and drug abuse. These groups are trained to develop scenes that an audience may identify with in order to help people clarify their values concerning social issues. The goal is to help people think through and make decisions beneficial to their health and well-being. Another program is the school team approach training, where the primary objective is to assist participating schools in prevention and reducing drug and alcohol abuse and associated disruptive behaviors. This is facilitated by encouraging and enhancing the development of a cooperative systems management approach to school governance in which the entire community assumes responsibility for problems and takes part in solution; and by facilitating the creation and maintenance of a positive school environment to reduce disruptive behavior. For more information, contact: Division of Alcohol and Drug Abuse Services Joe Foss Building Pierre, South Dakota 57501 Bob Anderson, Director (605) 773-3123 Tennessee The Department of Mental Health and Mental Retardation has been designated the sole authority in the state for alcohol and drug programs. The Division of Alcohol and Drug Services administers funds and oversees programs development. On the local level, needs assessments are carried out by regional planning boards, which include service division contracts directly with local programs for services. Community mental health centers do about three-fifths of the programming Drug and alcohol education is required by the state, and both the state Department of Education and the division offer curricula. In addition, the division offers teacher training for its K- 6 curriculum. The parent movement in the state is fairly new. There are about eight active groups, including MADD and RID chapters. For more information, contact: State Planning Office 309 John Sever State Office Building 500 Charlotte Avenue Nashville, Tennessee 37219-5082 Carol White, Federal Affairs Coordinator (615) 741-1676 Texas Drug and alcohol abuse prevention programs are funded and overseen by two separate state agencies. The Commission on Alcoholism administers programs through regional authorities. The state is divided into twenty-four regions. 73 The Drug Abuse Prevention Division of the Department of Community Affairs handles drug programming Both agencies provide technical assistance, training, and program planning and development. For more information, contact: Commission on Alcoholism 1705 Guadalupe Street Austin, Texas 78701 Ross A. Newby, Director (512) 463-5510 Drug Abuse Prevention Division 2015 South 1H 35 Austin, Texas 78741 Jim Bradley, Director (512) 463-5510 Utah The State Division of Alcoholism and Drugs coordinates education, prevention, and training programming statewide. It oversees planning and contracting for programs at the local level, providing links with other state-level agencies (such as mental health, aging, education, PTA, and the legislature) and also provides limited direct services. Prevention programming is decentralized, with most programs provided by local schools, counties, courts, and private organizations. The state is divided into planning districts for funding and administration. Direct services provided by the division include mass media campaigns, model curriculum development, audio-visual lending library, research and evaluation, and training. In addition, it sponsors the statewide Governor's Youth Council on Alcohol. For more information, contact: Division of Alcoholism and Drugs 120 North 200 West, 4th Floor Salt Lake City, Utah 84103 F. Leon Povey, Director (801) 538-3939 Vermont The Alcohol and Drug Abuse Division Intervention Program provides funds and oversees prevention efforts in the state. Nine regionally based intervention specialists, supported by central staff, plan, develop, follow up, and evaluate a variety of prevention programs jointly with local individuals and groups. Programs are aimed at the general public, schools, workers, and grass-roots organizations. The division funds about ninety rural, community-based programs each year. In addition, it plans statewide initiatives such as public service announcements and other large-scale projects. For more information, contact: Office of Alcohol and Drug Abuse Programs 103 South Main Street Waterbury, Vermont 05676 Richard Powell II, Director (802) 241-2170 74 Virginia The Virginia program is a statewide initiative designed to train student leaders to develop school-based peer resistance programs for prevention of alcohol and drug abuse and for the reduction of alcohol-related accidents among teens. Major features include state training for more than 400 youth and 200 adults, and fifteen regional conferences and two state conferences on alcohol and drug abuse. In 1986, the state developed a pilot Drug Abuse Resistance Education program. The primary focus is teaching elementary students general skills for coping with life and instructing students in ways to apply these skills to specific events that may threaten their general health. The program is funded by a grant from the Criminal Justice Service for $69,000 and is a cooperative effort between the State Police and the Department of Education. A uniformed police officer is assigned to teach the program fulltime in the classroom. For more information, contact: Division Office of Substance Abuse Services P.O. Box 1797 Richmond, Virginia 23214 Wayne Thacker, Director (804) 786-3906 Washington The Prevention/Early Intervention Program of the Bureau of Alcohol and Drug Abuse Prevention allots funds to thirty-five county units for the development of local plans. These county plans must be geared toward three types of projects: comprehensive K-12 school-based curriculum that includes knowledge, decisionmaking, coping skills, and self-esteem; student assistance programs; and community organization, which includes parent education and support groups. The focus of the programs is establishing a partnership between state, county, schools, youth, parents, service organizations, business and industry, churches, etc. For more information, contact: Bureau of Alcohol and Substance Abuse Mail Stop OB-44W Olympia, Washington 98504 Glen Miller, Director (206) 753-5866 Wisconsin The Department of Health and Social Services' Office of Alcohol and Other Drug Abuse is the single state authority for prevention programs. Wisconsin has experienced a growth in the areas of community development core group citizen initiatives. This model has become the basis for alcohol and other drug abuse prevention in social policy formulation, citizen/parent action, school curriculum, and intervention programs. Volunteer involvement has grown at the community and state level, as well as in the workplace and in the Native American reservation community. There are more than sixty public school districts that have prevention and early intervention programs. For more information, contact: 75 Office of Alcohol and Other Drug Abuse P.O. Box 7851 Madison, Wisconsin 53707 Larry Monson, Director (608) 266-2717 West Virginia The Division on Alcoholism and Drug Abuse, of the Department of Health, is the single state agency for alcoholism and drug abuse programs. It contracts with fourteen comprehensive community behavioral health centers to provide services. Prevention activities include working with schools, participating in MADD and SADD groups, coordinating Chemical People task forces, and conducting media campaigns. The division funds several innovative programs and public awareness campaigns, including D.A.N.C.E. (Drugs are Not Constructive Entertainment), a media campaign and social events for teens; and prevention and early intervention for high-risk populations, specifically family members of alcohol abusers and high school students in driver education classes. Other programs are Project Integrity, a training program for dealing with substance abuse problems of the elderly; peer facilitator training for junior high, high school, and college students; the Natural Helpers Project; and the Youth Outdoor Development Project, a summer employment/personal development program for high-risk youth. For more information, contact: Division of Alcohol and Drug Abuse State Capitol 1800 Washington Street East Charleston, West Virginia 25305 Jack Clohan, Jr., Director (304) 348-2276 Wyoming The Office of Substance Abuse Programs, which is within the Division of Community Programs, funds and oversees prevention activities in the state. Programs are administered at the local level by both mental health agencies and free-standing substance abuse agencies. State funding is based on the number of hours of staff time expended rather than on a per capita basis. There are about twenty-five agencies in the state that provide some degree of prevention service. Each agency devises annual program goals and strategies to meet local needs. For more information, contact: Office of Substance Abuse Programs 2300 Capitol Avenue Cheyenne, Wyoming 82202 Jean DeFratis, Director (307) 777-7115, ext. 6494 76 PART FOUR: Additional Resources 77 City Responses To Drug Abuse This is an annotated listing of drug abuse prevention programs in the Mayors' Clearinghouse on Drug Control. The listing includes community education programs, police-school programs, treatment and counseling programs, municipal employee programs, and community task forces or advisory commissions on substance abuse programs. These listings were last updated in November 1986. For further information on the Mayors' Clearinghouse, contact: United States Conference of Mayors 1620 Eye Street, N.W., 4th Floor Washington, D.C. 20006 (202) 293-7330 Alcohol and Drug Abuse Prevention Education: Survey of The States This report is the product of a joint effort by the National Association of State Boards of Education's (NASBE), Alcohol Education Guidelines Project in collaboration with the Connecticut State Department of Education. This report discusses a policy framework and implementation of alcohol and drug abuse prevention programs in K-12 school programs. It also relates to teaching, monitoring and evaluating programs, and staffing programs in the state education agency. For further information, contact: The Alcohol Education Guidelines Project National Association of State Boards of Education 701 North Fairfax Street, Suite 340 Alexandria, Virginia 22314 (703) 684-4000 American Bar Association Policy Recommendation on Youth Alcohol and Drug Problems This report was adopted by the American Bar Association House of Delegates in July 1985. The report makes recommendations for policy changes dealing with youth and substance abuse prevention. Recommendations are in the areas of: illegal sales of alcohol to minors; youth drug paraphernalia law; dram shop and host liability; child custody and visitation; consent to treatment; and child abuse and neglect laws. For further information, contact: American Bar Association Section of Individual Rights and Responsibilities 1800 M Street, N.W. Washington, D.C. 20036 (202) 331-2273 Strategies for Controlling Adolescent Drug Use This report from the Rand Corporation by J. Michael Polich, Phyllis L. Ellickson, Peter Renter and James P. Kahan, which gives a detailed analysis of drug use prevention techniques that could curtail drug abuse or prevent the onset of drug use by young people. For further information, contact: The Rand Corporation 1700 Main Street P.O. Box 2138 Santa Monica, California 90406-2138 (213) 393-0411 78 Drug Use Among American High School Students, College Students, and Other Young Adults This is a study of national trends in drug use among the youth. It gives data on different drugs in different geographical locations and the current trends for drug use. This document is usually updated every two or three years. For further information, contact: National Institute on Drug Abuse Alcohol, Drug Abuse, and Mental Health Administration U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, Maryland 20857 (301) 443-6480 State Laws and Procedures Affecting Drug Trafficking Control: A National Overview This unique report looks into the aspects of state laws affecting the investigation and prosecution of individuals involved in drug trafficking and related activity. The report covers ten areas: bail, sentencing, forfeiture, group criminality (encompassing conspiracy and racketeering), electronic surveillance, witness immunity and protection, grand juries, currency transaction reporting, state revenue files access, and intergovernmental cooperation (including the sharing of intelligence and statistical data). : For further information, contact: The National Criminal Justice Association 444 North Capitol Street, N.W., Suite 608 Washington, D.C. 20001 (202) 347-4900 State Resources And Services Related To Alcohol And Drug Abuse Problems This is a profile of state alcohol and drug abuse programs. The information is categorized by: funding levels and sources; client admission characteristics; availability of other treatment-related data; top policy issues; major unmet needs; and significant changes in treatment and/or prevention services. For further information, contact: The National Association of State Alcohol and Drug Abuse Directors, Inc. 444 North Capitol Street, N.W., Suite 520 Washington, D.C. 20001 (202) 783-6868 79 1 on TOTO m REMARKS: NATIONAL CONFERENCE OF STATE LEGISLATURES OLD EXECUTIVE OFFICE BUILDING/RM 450 MARCH 10, 1989 I AM VERY PLEASED TO BE HERE. I WOULD LIKE TO THANK THE PRESENT AND PAST OFFICERS FOR YOUR GRACIOUS INVITATION -- SAMMY NUNEZ (Noo-nez), LEE DANIELS, TED STRICKLAND. THANK YOU ALL. THE LAST TIME I SPOKE TO YOU, WE WERE IN THE MIDDLE OF AMERICA, IN THE MIDDLE OF SUMMER, AND IN THE MIDST OF A TOUGH CAMPAIGN YEAR. 2 FATE HAS SMILED ON US SINCE THAT JULY DAY IN INDIANAPOLIS. THEN, WE WERE ALL CANDIDATES. TODAY, EVERYONE IN THIS ROOM IS A WINNER. FOR THOSE OF YOU WHO ARE REPUBLICANS, YOU DISCERNING DEVILS, THERE WAS A TIME WHEN I THOUGHT I'D DRAG ALL OF YOU DOWN BUT, NO, HERE WE ARE! FOR THOSE OF YOU WHO ARE DEMOCRATS, I CLAIM ABSOLUTELY NO CREDIT WHATSOEVER BUT "WELL DONE." IN ALL SINCERITY, I WANT TO CONGRATULATE EVERY LEGISLATIVE LEADER IN THIS ROOM, DEMOCRATIC AS WELL AS REPUBLICAN. You WON MORE THAN A POLITICAL VICTORY. 3 You WON THE HIGHEST HONOR OF ALL -- THE OPPORTUNITY TO SERVE. THE PROBLEMS THAT CONFRONT OUR COUNTRY AS WE NEAR THE END OF THIS CENTURY OFTEN SEEM BIGGER THAN OUR ABILITY TO SOLVE THEM. AND THEY ARE -- IF WE FACE THESE PROBLEMS AS ONLY PARTISAN DEMOCRATS OR REPUBLICANS, AS PAROCHIAL MEMBERS OF A REGION, OR A FACTION, OR AN INTEREST GROUP. BUT BY WORKING TOGETHER, AS AMERICANS, WE CAN LICK ANY PROBLEM -- NO MATTER HOW BIG, HOW COMPLEX OR HOW DEEPLY ROOTED IT MAY BE. 4 TRUE, THERE ARE ALWAYS NAYSAYERS WHO BELIEVE WE WILL NEVER CLEAN UP THE ENVIRONMENT; THAT WE WILL NEVER SHELTER THE HOMELESS; THAT WE WILL NEVER END THAT AGE-OLD AFFLICTION OF MANKIND, POVERTY -- POVERTY OF KNOWLEDGE AND SKILLS, POVERTY OF OPPORTUNITY, POVERTY OF HOPE. BUT THE CYNICS NEVER TAKE INTO ACCOUNT ONE OF THE GREAT SUCCESS STORIES OF OUR TIMES -- STATE GOVERNMENT. IN THIS DECADE, POWER FLOWED FROM WASHINGTON TO AUSTIN, TO ATLANTA, TO SACRAMENTO AND TO EVERY OTHER STATE CAPITAL. 5 WITH THIS POWER CAME NEW RESPONSIBILITIES. AND HISTORY WILL REMEMBER THAT YOU MET YOUR BROADENED RESPONSIBILITIES WITH DISTINCTION. I KNOW FUNDS AT ALL LEVELS OF GOVERNMENT ARE TIGHT. I KNOW YOU ARE CALLED UPON TO MAKE HARD CHOICES, AS I AM. BUT, BY AND LARGE, YOU ARE MEETING THE CHALLENGE OF A FRUGAL AGE BY DEVISING CREATIVE NEW SOLUTIONS TO THE AGE-OLD PROBLEMS OF CARE AND CONCERN FOR THE VERY YOUNG, THE VERY ELDERLY, THE DISADVANTAGED AND THE DISPOSSESSED. 6 So WHENEVER I SEE A PROBLEM THAT SOME SAY IS INSURMOUNTABLE, I DRAW INSPIRATION FROM WHAT YOU ARE ALREADY DOING IN THE STATES. THE RESILIENCE OF STATE GOVERNMENT IN THE 1980s VINDICATES THE WISDOM OF THE FOUNDING FATHERS, AND FOREVER DISCREDITS THOSE WHO WOULD HAVE WASHINGTON DO IT ALL. LET ME ASSURE YOU: I WILL PRESERVE AND PROTECT A HEALTHY BALANCE, A SHARING OF POWER, BETWEEN THE STATES AND WASHINGTON. FEDERALISM WORKS. 7 I REMEMBER MEETINGS I HAD YEARS AGO WITH GOVERNORS DISCUSSING THE SOCIAL ISSUES. I LEARNED A LOT. THE STATES ARE ON THE CUTTING EDGE. GOVERNORS MUST DEAL IN WHAT WORKS. As YOU KNOW, ONE POLICY AREA CLEARLY DESIGNATED AS A PRIME RESPONSIBILITY OF THE FEDERAL GOVERNMENT IS OUR NATIONAL DEFENSE. So PERHAPS THE APPEAL I AM GOING TO MAKE TO YOU TODAY WILL BE ALL THE MORE UNPRECEDENTED. 8 THE TIME HAS COME FOR ME TO ENLIST YOUR ENERGY AND EXPERTISE IN A DIFFERENT KIND OF NATIONAL SECURITY CRISIS -- THE THREAT OF DRUG ABUSE TO THE HEALTH AND THE VERY FUTURE OF OUR NATION. CRACK. HEROIN. P.C.P. THESE DRUGS ARE A PLAGUE THAT LEAVES AN AFTERMATH OF SHATTERED MINDS, RUINED BODIES AND WASTED POTENTIAL. No STATE IN THE UNION IS IMMUNE TO THIS PLAGUE. DRUG CRIMES HAVE CLAIMED THOUSANDS OF LIVES, AND TURNED WHOLE COMMUNITIES UPSIDE DOWN FROM THE EASTERN SEABOARD TO THE PACIFIC COAST. 9 IT IS BECOMING APPARENT THAT OUR STRUGGLE AGAINST THE DRUG TRADE IS THE MORAL EQUIVALENT OF WAR. As WITH EVERY BATTLE THIS COUNTRY HAS EVER FOUGHT, WE ARE ALL IN THIS TOGETHER -- AS AMERICANS. AND AS WITH ANY WAR, WE MUST HAVE A STRATEGY. OUR STRATEGY IS FOUR-PRONGED: 1) EDUCATION; 2) REHABILITATION; 3) LAW ENFORCEMENT; AND 4) INTERDICTION. I AM ENCOURAGED TO SEE so MANY STATE GOVERNMENTS FORMING INTRA-STATE DRUG TASK FORCES, AND INTER-STATE PANELS TO SHARE RESOURCES AND INTELLIGENCE. 10 EVERY STATE SHOULD JOIN THIS COMMON EFFORT. AND EVERY STATE SHOULD LOOK FOR WAYS TO TOUGHEN ITS DRUG LAWS. THE FEDERAL GOVERNMENT, JUST LIKE THE STATES, IS ANIMATED BY A NEW GET-TOUGH ATTITUDE ON DRUGS. WE'VE STIFFENED THE FEDERAL SENTENCE FOR DRUG TRAFFICKING TO A MAXIMUM OF LIFE. WE'VE TOUGHENED PENALTIES FOR DRUG DEALERS WHO USE CHILDREN TO DEAL DRUGS, OR WHO SELL DRUGS To CHILDREN. AND IF YOU COMMIT A DRUG-RELATED MURDER, OR KILL A COP, THE TOUGHEST SENTENCE YOU CAN RECEIVE IS THE TOUGHEST SENTENCE THERE IS -- DEATH. 11 WE'VE ALSO INCREASED OUR RESOURCES AS WE'VE STIFFENED SENTENCES. SINCE 1981, THE FEDERAL ANTI-DRUG BUDGET HAS GROWN BY NEARLY 370 PERCENT. BUT MORE WAS NEEDED, SO I AM ASKING THE CONGRESS FOR $6 BILLION FOR OUR ANTI-DRUG PROGRAM IN 1990. MORE THAN $4 BILLION WILL BE SPENT TO PROVIDE GRANTS TO STATE AND LOCAL LAW ENFORCEMENT AGENCIES, TO BEEF UP FEDERAL ENFORCEMENT, AND TO ENHANCE OUR PROSECUTION, DETENTION AND INTELLIGENCE CAPABILITIES 12 THIS INCLUDES SUSTAINING THE $150 MILLION DRUG GRANT PROGRAM, so THAT THE DEPARTMENT OF JUSTICE CAN HELP STATE AND LOCAL LAW ENFORCEMENT AGENCIES CATCH CRIMINALS AND WARN KIDS AWAY FROM DRUGS. ANOTHER SHINING EXAMPLE OF FEDERAL AND STATE COOPERATION IS THE SEIZURE AND FORFEITURE OF ASSETS FROM DRUG DEALERS. STATE AGENCIES THAT COOPERATE IN DRUG CASES WILL SHARE THE BENEFITS FROM THE SALE OF YACHTS, PLANES AND CARS USED IN DRUG DEALS. 13 To CONVERT THE PROFITS OF VICE TO FINANCE OUR WAR AGAINST THE MULTI-BILLION DOLLAR DRUG EMPIRE IS MORE THAN GOOD FINANCIAL SENSE. IT IS SWIFT JUSTICE EVEN WITH THESE PROGRAMS, THE CAMPAIGN AGAINST DRUG ABUSE WILL BE A HARD-FOUGHT WAR THAT WILL LAST FOR YEARS. PERHAPS WE SHOULD TAKE INSPIRATION FROM A NATION AT WAR ALMOST FIFTY YEARS AGO. As BRITAIN FACED AN ADVERSARY THAT TESTED THE COURAGE AND CHARACTER OF ITS PEOPLE, WINSTON CHURCHILL VOWED TO NEVER SURRENDER. 14 IN TODAY'S WAR AGAINST THE PUSHERS, WE MUST -- AS A PEOPLE -- DRAW FROM THESE SAME DEEP WELLS OF NATIONAL PURPOSE TO SUMMON A SPIRIT OF DEFIANCE. BUT OUR SINGLE, MOST IMPORTANT TASK IS TO KEEP KIDS OFF DRUGS AND OUT OF TROUBLE. TOWARD THIS END, I AM PROPOSING A $1.1 BILLION ALLOCATION FOR DRUG EDUCATION AND PREVENTION -- A 16 PERCENT INCREASE OVER 1989. 15 SOME $367 MILLION OF THIS WILL GO TO THE DRUG FREE SCHOOLS AND COMMUNITIES PROGRAM, TO HELP KEEP DRUGS OUT OF OUR SCHOOLS, CAMPUSES AND NEIGHBORHOODS -- AN INCREASE OF $12 MILLION. THE PROGRAMS ARE MANY. You WILL BE ABLE TO TAKE THE LEAD IN THIS EFFORT, SINCE MORE THAN 80 PERCENT OF THE FUNDS OF THE DRUG FREE SCHOOLS AND COMMUNITIES PROGRAM WILL BE ALLOCATED TO THE STATES AND TERRITORIES. As YOU MAY HAVE HEARD, WE CAN ALREADY TAKE HEART FROM SOME GOOD NEWS FROM THE CLASSROOMS OF AMERICA. 16 ACCORDING TO THE 1988 NATIONAL HIGH SCHOOL SENIOR SURVEY, THE PROPORTION OF SENIORS USING ILLICIT DRUGS DURING THE PRIOR YEAR FELL FROM 42 PERCENT IN 1987 TO 39 PERCENT IN 1988. THIS COMPARES WITH THE PEAK YEAR OF 1979, WHEN AN ASTOUNDING 54 PERCENT OF ALL AMERICAN HIGH SCHOOL SENIORS USED DRUGS. STILL, 39 PERCENT IS TOO MUCH. WE WILL SPEND MONEY TO GET THE JOB DONE, BUT WE NEED SOMETHING MORE -- AN ATTITUDE OF INTOLERANCE. 17 LET ME TELL YOU, PRESIDENTS USUALLY DO NOT SPEAK IN FAVOR OF INTOLERANCE. BUT THE DAY MUST SOON COME WHEN THIS NATION IS UTTERLY INTOLERANT OF SO-CALLED CASUAL DRUG ABUSE. THEN, AND ONLY THEN, WILL WE BE ABLE TO DECLARE VICTORY. OVER THE NEXT FOUR YEARS, WE WILL FACE MANY COMMON CHALLENGES -- TO OUR ENVIRONMENT, TO OUR PROSPERITY, TO OUR COMPASSION FOR THOSE WHO HAVE YET TO FULLY PARTICIPATE IN THE AMERICAN DREAM. THE CHALLENGE OF DRUG ABUSE WILL TEST OUR RESOLVE AND OUR METTLE AS A PEOPLE. 18 I PLEDGE, LEADER TO LEADER, TO WORK WITH YOU AND YOUR STATE GOVERNMENTS IN THIS STRUGGLE. BILL BENNETT AND I WILL LEAD THE FIGHT AGAINST DRUGS ON ALL FRONTS. JUST AS WAR TESTED AMERICA AND OUR ALLIES IN THE 1940s, SO OUR PEOPLE ARE UNDERGOING A TEST OF OUR NATIONAL WILL TODAY. To PARAPHRASE CHURCHILL, WE SHALL NOT FLAG OR FAIL. WE SHALL GO ON TO THE END FIGHTING THE SCOURGE OF DRUG ABUSE, WITH GROWING CONFIDENCE AND GROWING STRENGTH WE SHALL NEVER SURRENDER. 19 WITH YOUR HELP, AND YOUR LEADERSHIP IN THE STATES, I KNOW THAT WE SHALL ALSO PREVAIL. THANK YOU. ###