Drug Control Policy Director Talks Prevention
MICHEL MARTIN, host:
I'm Michel Martin, and this is TELL ME MORE from NPR News.
We have our regular Friday features for you. We'll be talking politics, race and gender. In Faith Matters, we'll ask if and why there's still a glass ceiling for women in leading faith communities. We'll be speaking to an author and a radio host who's thought deeply about this subject. She also happens to be a Roman Catholic nun. That's in just a few minutes. And the Barbershop guys will debate the NAACP verses Tea Party war of words.
But first, a newsmaker interview with the man tasked with leading the nation's effort to reduce illegal drug use, R. Gil Kerlikowske. He is the director of the Office of National Drug Control Policy, the so-called drug czar. This week he brings news that one of the leading priorities of his office are drugs that aren't actually illegal. They might even be sitting in your bathroom cabinet right now.
Director Kerlikowske is here with me in our Washington, D.C. studio. Welcome. Thanks for joining us.
Mr. R. GIL KERLIKOWSKE (Director, Office of National Drug Control Policy): Good, and thanks for having me.
MARTIN: And I do understand that you actually don't like that term drug czar or the term war on drugs, and we'll talk about why that might be a little later.
But first, I want to get to the news of your announcement yesterday. You described the scope of the problem. You said among 12th graders surveyed, seven of the top 10 misused drugs are legal pharmaceuticals. You said that one in four active duty military personnel report misusing prescription drugs.
And you also say that this addiction to pain killers, the problem with legal pain killers spans every gender, race, ethnicity, education and employment level in all regions of the country. How did we get here?
Mr. KERLIKOWSKE: We got here in a couple ways. One is that we have found that prescription drugs are so widely available and so easily available. And young people don't recognize the dangers because they say, well, after all, it's a prescription or it's in my parents' medicine cabinet. And these are very addictive. These are very powerful. And of course we know that fatalities from drug abuse now outpace gunshot wounds in this country. That is primarily driven by these prescription pharmaceutical drugs.
MARTIN: Is this a path of least resistance issue, which is that because law enforcement has been so aggressive in recent years and penalties have increased for certain kinds of drug use so dramatically that people are seeking these out? Or are there more of them in the population than there used to be? Are more of them being prescribed - they're just more available?
Mr. KERLIKOWSKE: You're right on all the counts. A number of years ago, about 10 or so years ago, there was a large meeting with doctors and they were saying, look, you're not really treating pain the way it should be. You're under-prescribing. And so we have seen a dramatic increase in availability in the number prescriptions written.
So these are more widely available. People don't recognize the dangers. And, you know, also, there's not a good program for people to clean out their medicine cabinets. You know, we're very environmentally conscious anymore and people don't want to flush these down the toilet or hurt the environment. And so they don't have a good way of disposing of those. And so we're working with Congress to help in that area also.
MARTIN: Is it your sense that this is - I mean obviously if it touches this many people, then the problem arises from any number of sources. But is it your sense that some of this is in fact pain management gone awry? Or that people really don't understand that these are not to play with?
Mr. KERLIKOWSKE: It's a combination of all of these things. We don't recognize them because they're prescriptions and we don't recognize the dangerousness. We know that they're more widely available. And so when you add all of these things together the other part is we've really taken our eye off the ball when it comes to these prescription drugs.
When I was getting ready for confirmation a year ago and was told that these overdose fatalities were greater than gunshot wounds in this country, I was surprised.
MARTIN: And you're a former police chief, so...
Mr. KERLIKOWSKE: And I actually thought, like, wow, you know, I keep up with this data. I look at this. So I, of course, went out informally and tested all of my friends and colleagues. And they didn't realize it either. So we need to bring attention. And I can't thank you enough for bringing attention to this issue today.
MARTIN: Well, we want to talk about some of the other aspects of your strategy and the focus of your office. And over the course of the week in preparation for this conversation we spoke to a number of people who are on the front lines of this problem.
I want to play one clip from a conversation we had with Ed Reina of the Tohono O'odham Nation. He's the director of public safety. His reservation's located in Arizona. It's on the U.S./Mexico border. He told us in 2010 the Justice Department reported that 5 to 10 percent of all marijuana grown in Mexico is making its way on their to the country through their tribal lands. I just want to play a short clip of what he had to say. Here it is.
(Soundbite of clip)
Mr. ED REINA (Director of Public Safety, Tohono O'odham Nation): The real issue is the prevention and intervention efforts that need to be done throughout the United States to decrease the demand for these drugs.
MARTIN: Now, you know, he's got his issue. But as of course you know, in Mexico, the issue is even more dramatic. This year alone some 23,000 people are estimated to have been killed in drug-related killings and the president of Mexico says the same thing. It's really a demand problem on the U.S. side. What about that?
Mr. KERLIKOWSKE: They're right. My colleagues, including Ed and others, don't talk about a war on drugs. They talk about, we can't arrest our way out of the drug problem in this country. So we have to focus on reducing demand. And as you know, Secretary Clinton now on several occasions has said this is a shared responsibility and the United States has to recognize it.
So how do we go about reducing that demand in the country? Well, the first is in the president's 2011 budget request, he has asked for a 13 percent increase in prevention funding, which is the largest increase in some time. We also know in the last number of years about prevention programs that work. And oftentimes people think, well, we won't really prevent this. We know that with the right messages, young people can be prevented from engaging in drug use.
MARTIN: If you're just joining us, this is TELL ME MORE from NPR News. We're speaking with Gil Kerlikowske. He's the director of the Office of National Drug Control Policy. He just had a major announcement this week and we're talking to him about that, as well as the other challenges his office faces.
The target set in this strategy for the year 2015, the plan is to cut the number of chronic drug users by 15 percent and reduce drug-induced deaths like overdoses by 15 percent. Now, some people might think that's not a big number, but one of the experts we talked to this week says it's actually a very big number and he questions whether it's even possible.
We talked to Scott Henggeler. He's a professor at the Medical University of South Carolina. He specializes in family addiction treatment. And I'll just play a clip of what he had to say if people missed that conversation. Here it is.
Professor SCOTT HENGGELER (Medical University of South Carolina): I think they are extremely ambitious. And I think if you could say a 5 percent decrease, that would be a phenomenal change. But being ambitious, I think they can be achieved.
Mr. KERLIKOWSKE: I think there are several ways that we're looking at. One is that if you look in the last 10 years in the United States, the United States has made great improvements in reducing crime across the country. And it wasn't because of just better policing or more engaged communities, et cetera.
It was because of innovation and collaboration. Law enforcement agencies working with schools, working with community groups, a whole host of ways of being innovative. We have never applied that same strategy to drug problems in this country. We have looked at the criminal justice system as one silo. We've looked at a prevention program somewhere else and we've looked at treatment and we know that treatment works and we know that treatment is half the cost of incarceration. We have never melded together.
And when I left Seattle after nine years as chief of police, I could not name five treatment professionals. If I knew then what I know now as a result of this job, I would have figured out a lot more ways to collaborate with them.
MARTIN: One of the arguments, though, that many people make is that just our whole philosophy toward drug use is just flawed, that there are those who of course who favor a dramatic liberalization of drug laws.
That they argue really the issue is prohibition and that if we have the same attitude toward illegal drugs now that we had to with prohibition, it didn't work then, it's not going to work now. And what do you say to that?
Mr. KERLIKOWSKE: Well, we know that certainly California is poised to and will be voting on legalizing small amounts of marijuana. And that vote is scheduled for November of this year.
There are a number of studies and a number of pieces of information that really throw that into the light of saying that, look, California is not going to solve its budget problems, that they have more increase or availability if drugs were, or marijuana, was to become legalized. That in fact you would see more use. That you would also see a black market that would come into play. Because why wouldn't in heaven's name would somebody want to spend money on tax money for marijuana when they could either use the underground market or they could in fact grow their own.
So there are a whole lot of good reasons why we don't want to see drugs legalized. And that's why the Obama administration has a very clear and direct opinion on that.
MARTIN: And, finally, before we let you go, please just tell us a little bit more about yourself. You mentioned you're the chief of the Seattle Police Department for some nine years, but you headed three other departments before that and then you've laid out clear goals for yourself. I am curious why you wanted to do this job after such a long career in law enforcement.
Mr. KERLIKOWSKE: Well, you know, it was interesting because nine years is a lifetime as a chief of police in a big city. It's actually about three times longer than the average lifespan. And so when I was called about this job I thought, well, maybe they're talking to me about a law enforcement position. And they talked to me about this. And I could not have been more pleased.
This is the most interesting and fascinating job. It has helped me recognize that we should be working together to keep young people off drugs. That we should strongly support treatment programs that are effective and work. And that also, by the way, my international travels on behalf of the administration have shown me that this isn't just the United States' problem.
What I've seen in Mexico, Colombia, Russia, Afghanistan is even in some of the most impoverished nations in the world, addiction problems that are significant. And we need to we're all in the same lifeboat on this drug issue and we need to be a lot smarter about how we're dealing with it and that's what we're hoping to do.
MARTIN: We only have about a minute left, but what gives you the most sense of optimism? As you've heard, there are those who say that just people just, some of our listeners even have said people just like the idea, some people just are going to like getting high. There's nothing you can do.
Mr. KERLIKOWSKE: You know what gives me a lot of optimism is that as I've traveled around the country and visited a number of treatment centers and met with people. I have talked to people who have become, as they say, clean and sober. They're back with their families. They're back being productive. They're back in their neighborhoods. And people don't often recognize that the stigma that is attached to drug addiction, and yet people overcome that and are quite successful all the time.
The second optimistic part about the job is I have met with hundreds and hundreds of young people, high school students and others who have gone through, really, tough circumstances and yet they have made a firm commitment not to be involved in drugs and to do a great job with their lives.
MARTIN: Well, we hope this will be the first conversation and not the last one.
Mr. KERLIKOWSKE: Thank you.
MARTIN: Gil Kerlikowske is the director of the Office of National Control Policy. He was kind enough to join us here in our Washington, D.C. studio. We still need to hear more about why you don't like that war on drugs term. So you'll have to come back and tell us. Thank you so much for joining us.
Mr. KERLIKOWSKE: Thank you.
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