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Alcoholism and Drug
Abuse
W
hen I was a senior
medical student at Emory University the chairman of the Psychiatry
Department, Dr Bernard Holland, a mentor and advisor, who had taken
a special interest in me, asked if I would like to do a one year
fellowship in his department right after graduation instead of
leaving for my internship. He had received a grant from the city of
Atlanta to study the roughly 50,000 arrests a year for public
drunkenness and to make recommendations as to how they could be
better handled.. I, along with two psychiatric residents, was to
conduct the study.
It turned out that the bulk of the 50,000 arrests could be
attributed to around 6,000 individuals, roughly half white and half
African-American and almost entirely men. I spent countless hours in
the court room and the Atlanta city jail interviewing arrestees
almost all of whom were chronic alcoholics. The bulk of them, if not
first offenders, were sentenced to 30 days at the city’s prison farm
where they were deprived of alcohol and fed a wholesome diet of the
produce they themselves helped to grow. However, at the end of their
sentence many had nowhere to go, no home, no job, and usually no
family that wanted anything to do with them. They invariably went to
the nearest bar got thoroughly drunk and where back in jail that
night. I realized that most of these men were drinking only between
prison sentences which might be as little as twelve times a year.
Their problem had become less alcohol than the inability to break
the revolving-door cycle they were in.
I identified a handful of men with whom I had built a relationship
and who seemed sincerely interested in turning their lives around. I
convinced them to take the drug Antabuse which if combined with
alcohol caused violent vomiting thereby deterring any drinking. The
pill had to be taken every day and, to be sure they were consumed,
they had to be swallowed in front of me. This kept them sober. I
then rented a building near the city jail which we did up as a
hostel. Several of the alcoholics had been in the building trades
and gave their labor to make it an attractive residence. I arranged
to have a job counselor from the Georgia Department of Labor
assigned to the project and hired a social worker. Within weeks I
had a group of men who were sober, holding down a job, and living in
relatively comfortable surroundings. Of course a few disappeared,
stopped taking the Antabuse, and went back to drinking. But there
were many stunning successes. One man considered to be among the
most hopeless and recidivist cases proved the most responsive. He
had been a successful meat cutter and had been widely respected in
his trade. Within six months he went from being a hopeless drunken
bum on the streets to a successful employee with a good steady
income, a new car, and reunited with his wife and children, a nice
home to live in.
News of the success with this initial group spread through the
community of habitual drunks in the city. Soon we were inundated by
requests to be on the program. Working with the judges in the
municipal court, arrested drunks were screened and offered either a
sentence of 30 days at the city prison farm or 30 days staying in
the community provided they came in every morning and took an
Antabuse pill. During that month we worked with them to get
employment and accommodation. Perhaps 20 to 30 per cent of the white
arrestees were able to turn their lives around. With
African-Americans, most of whom suffered lives of quiet desperation,
even when they were not drinking, the success rate was lower. It was
a time when Atlanta remained segregated. African-Americans were
treated contemptuously in the court system and given few if any
breaks to overcome their problems. There was not a single practicing
African-American psychiatrist in the state of Georgia and no
out-patient psychiatric facility for African-Americans.
The year after the study the number of arrests dropped by 50 per
cent saving the city hundreds of thousands of dollars. But after I
left, the program began to slowly erode. It required intensive,
energetic, dedicated commitment which I had at that stage in my
career. In the absence of someone in that role the forces of moral
judgment, vengeance, and punitive retribution towards these sick
people returned. I published an article on the program in the
scientific literature that spurred some other cities to try the same
kind of approach. But few wanted to spend the money and had trouble
finding physicians who saw working in such an environment as any
benefit to their careers.
In July 1963 I moved on to begin my internship at King County
Hospital in Seattle (now Harborview Hospital). As the charity
hospital for the city a high percentage of the patients who ended up
there had a drinking problem. My year on the streets and in the city
jail in Atlanta gave me a leg up over my fellow interns, largely
from Harvard, Yale or Columbia, in treating these people.
I was then out of the substance
abuse business for three years while I served my time in the US
Army. In July 1967 I went to Stanford University Medical Center to
finish my residency in psychiatry and to do a masters degree in
anthropology. Early in the summer of 1968 one of the faculty members
opened a seminar by announcing to our small group of residents, that
a doctor at the University of California San Francisco, David Smith,
had opened a free medical clinic in the Haight-Ashbury district of
the city and was seeking volunteer physicians to help staff it. It
was the so-called “Summer of Love” and thousands of young people
were pouring into the city. Anti-war, quietly rebellious through
their life style, and heavily into drugs the hippie army included a
wide range from the most ardent idealists to the psychologically
alienated and mentally disturbed. I signed up to work at the clinic
one night and one weekend day a week. Apart from the usual minor
health problems ranging from cut feet to the complications of
pregnancy the bulk of the complaints were drug related. Sometimes it
was bronchitis from chronic marijuana use, or the adverse effects of
a bad trip on LSD or occasionally a heroin overdose. Over the months
I became expert in treating these conditions.
At the end of my residency in July 1969 I returned to Atlanta on the
faculty of the psychiatry department at Emory Medical School. Part
of my job involved running a federally funded mental health center
on the south side of the city. It served a population of 45,000
universally poor and majority African-American residents. Among
these people was a small hardcore population of heroin addicts that
was rapidly expanding. I decided to set up a treatment program for
them, but in order to use the heroin substitute, methadone, I needed
to apply for a special license from the Food and Drug Administration
(FDA). With the license in hand I began treating a group of around
30 addicts on methadone maintenance. At the same time Atlanta was
developing its own exclusively white hippy community with the same
patterns of drug use I had seen in San Francisco. I donated my time
to provide free care for those who got into difficulty and also
began writing an anonymous column, under the pen-name “Dr Aquarius”
for the alternative newspaper The Great Speckled Bird. By word of
mouth and several newspapers articles I became publicly recognized
as the “drug expert” in the city and for that matter in the state.
In my own mind I was more “the one eyed man in the land of the
blind” because while my experience at the Haight-Ashbury Free
Medical Clinic made me more qualified than my fellow physicians in
Georgia I did not really consider myself a true expert in addiction
medicine.
Over the July 4th weekend 1970 a gigantic “rock festival” was held
in the little town of Byron, Georgia. Modeled on the Woodstock
Festival and with the support of Capricorn Records in nearby Macon
it attracted more than 300,000 people and many of the top performers
of the day. For four days this gathering of humanity constituted the
fifth largest city in the state. In preparation for the event I and
some other like-minded progressive physicians planned a program to
provide medical care for the festival-goers. With a series of small
tented first aid centers we operated around the clock from Friday
morning to Monday morning. We saw and treated more than 7,000
people, delivering three babies, setting broken bones, and taking
care of routine medical problems. The temperature was in the high
nineties all three days creating special problems. The taking of
drugs was ubiquitous. It involved the experienced counter-culture
hippy community, but also a large number of young rural Georgians
with little or no drug taking experience. Because of the heat, in
addition to drug consumption, beer was consumed in prodigious
quantities. People who normally knew better lay in an oblivious,
stuporous state in the searing heat of the sun becoming seriously
dehydrated. At times we had several dozen people on IV drips to
overcome their heat prostration. The largest problem was the adverse
reactions to drug taking by naïve, first time users, many of them
red-neck farm boys. Happily no one died. With almost no sleep for
three days I returned to Atlanta as tired as I had ever been in my
life.
By 1970, drug abuse hysteria was sweeping the country. GIs in Viet
Nam were getting addicted to heroin and studies of inner city crime
showed the perpetrators were overwhelmingly heroin addicts. Richard
Nixon against his natural inclinations and that of many of his
fellow Republicans decided to opt for an intensive focus on
treatment along with the traditional hard line law enforcement
efforts. Much of the credit goes to ‘Bud’ Egil Krogh a member of his
domestic policy staff dealing with law enforcement who convinced him
that treating addicts could result in a dramatic drop in crime rates
for which he could claim credit. (Krogh would later achieve
notoriety as one of the “White House Plumbers.”) Nixon created the
Special Action Office for Drug Abuse Prevention (SAODAP) directed by
Dr Jerome Jaffe. Federal money was made available to the states to
set up drug treatment programs and governors began giving the
problem a high priority. Governor Jimmy Carter was one of them. He
needed to appoint someone to be the head of a statewide treatment
program. As it was to focus primarily on heroin addicts that person
would need to have the FDA license to use methadone. Carter asked me
if I would take the job, initially to be on a one year leave of
absence from the Emory faculty. My transition from medical school
academic to gubernatorial staff member is described elsewhere (click
on Jimmy Carter.)
I went to work in the governor’s office on June 27th and the
deadline for the submission of the grant proposal for federal money
was June 30th. In an around-the-clock effort I met the deadline and
secured the funds that allowed me to launch a statewide initiative.
A college friend from Emory, Dr Robert DuPont, had set up a heroin
addiction treatment program for the District of Columbia, the
Narcotic Treatment Administration (NTA). It was a large scale
methadone operation for heroin addicts that drew heavily on
referrals from the District courts but was also available to any
addict voluntarily seeking treatment. I accompanied Governor Carter
on a trip to Washington DC to meet with Pentagon officials and to
testify before a Senate committee about the drug problems in
Georgia. I convinced him to spend the afternoon visiting the NTA. On
the flight back to Atlanta he asked if I could set up something
similar in Georgia.
The next six months were perhaps the most hectic of my life. I set
up neighborhood clinics across Atlanta with a large downtown intake
center in order to make treatment readily available and to get as
many addicts off heroin as quickly as possible. I also opened
treatment centers in the other major cities in State. Most were
out-patient clinics but I started one residential facility for
teenage addicts. Especially outside Atlanta I developed counseling
centers that were aimed primarily at drug users who were not heroin
addicts. By the end of the year we had more than 7,000 people in
treatment. I also had to sell the program to the public and the
state legislature. In the first year I gave 186 speeches around the
state. The drug issue had high visibility because of what Nixon had
done in Washington and in most of the states. We had constant media
attention. It was also a high visibility accomplishment that
Governor wanted to get maximum credit for. When he hosted the
Southern Governors’ Conference he proudly brought a group of them to
the intake center for a tour and a briefing from me.
Simultaneous with my efforts in Georgia other large-scale heroin
treatment programs were being started in other major cities
including, New York, Detroit, Chicago, San Francisco, Boston, and
Bob DuPont’s well-established program in DC. Faced with common
problems and in a pioneering role in largely uncharted territory a
high level of comraderie developed between the directors of these
programs. We decided to meet for a weekend every three months in one
of our cities so that we could spend several hours sitting together
exchanging experiences, sharing new ideas and generally picking each
other’s brains. I remember it with great pleasure as an experience
in which we were all working very hard in our respective locations,
constantly in the public eye, with heavy responsibility on our
shoulders, all willing to share and help others and all eager to
learn what we could that might make our jobs a little bit easier. I
particularly admired Dr Robert Newman director of the New York City
program that had more than 20,000 patients. He was an excellent
administrator, highly experienced and a constant source of new and
original ideas.
During this period of time I was also working with a colleague at
the Yerkes Primate Center of Emory University on developing an
animal model for alcohol dependency. Delirium tremens, the tremulous
and convulsive disorder resulting from the sudden cessation of
alcohol use, was a clear clinical entity in humans, but there was
some question as to whether it could be duplicated in animals. The
purpose for doing so was in order to test various experimental
treatments. Working with young chimpanzees over a six month period
of time we were able to replicate delirium tremens in them. We
published the work in Science generating considerable attention in
the addiction field.
One day I received a call to say that Egil “Bud” Krogh from the
domestic policy staff of the White House wanted to visit me and to
tour my program. He began his day in Atlanta with a private meeting
with Governor Carter. Only in the last year did he explain to me
that the decision had already been made in Washington to offer me
the job as the assistant director of SAODAP and his trip to Atlanta
was really just a courtesy on behalf of President Nixon to let
Carter know they were trying to hire me away. A week later when the
official job offer came it put me in a difficult position. I was
already deeply enmeshed in the secret plans for Carter to run for
president in 1976 and to go to work for a Republican administration
might seem highly disloyal not to mention putting me out of the
action with the embryonic campaign. On the other hand Carter was a
one term governor and it was unlikely that his successor would keep
me on. If the Carter campaign was not successful I would be in
trouble. I decided to discuss it with Carter. He encouraged me to
take the job with the agreement that I would stay in a central role
in the campaign returning regularly to Atlanta for the key strategy
meetings. And when he finally announced his candidacy publicly
(planned for late in 1974) I would resign from SAODAP and set up the
Carter campaign office in Washington.
I moved to Washington in November 1972 shortly after Nixon was
re-elected. In my new job as Assistant Director of SAODAP I was
primarily responsible for overseeing the treatment programs around
the country. Within twenty-four hours of my arrival I was on the
road traveling around the US holding hearings on the newly
promulgated regulations on the use of methadone for the treatment of
heroin addiction. I encountered intense questioning and criticism. I
had not been involved in the writing of the regulations, had barely
read them before I left on the tour but was suddenly the point
person selling these complex stipulations for the administration. It
was a real baptism by fire. Over time I became more knowledgeable
and confident with a steadily increasing grasp of how the federal
government worked and how to get things accomplished. I learned to
deal with policy makers at the highest level overcoming a natural
timidity and shyness. I also began traveling overseas, mainly to
Europe and Asia representing the US government either at conferences
or for bilateral discussions with the leaders of other government
about their drug control policies.
My main job was to work in collaboration with the National Institute
on Alcoholism and Drug Abuse and the state drug abuse authorities to
expand the treatment capacity for heroin towards the SAODAP goal of
being able to say “there should be no addict in the country who can
say I want treatment but there is no place I can get it.” I had at
my disposal a budget of several hundred million dollars which
enabled me to get people’s attention and to get them to carry out
the programs we wanted.. It had become apparent to me that in
addition to heroin addicts there was a significant group of young
people taking a variety of mostly prescription drugs. Some took just
barbiturates others took simultaneous a variety of other substances.
There was no specifically targeted treatment model for these people.
I put out a request for proposals inviting treatment programs around
the country to come up with innovative experimental models to treat
these people. We had many submissions and an independent panel of
experts to chose the six initiatives we would fund. I was happy when
two of the winners turned out to be King County Hospital (now Harbor
View) in Seattle where I had interned and David Smith’s
Haight-Ashbury Free Medical Clinic in San Francisco where I had
worked as a volunteer.
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In an era very different from today SAODAP had been set up
to attract the best and brightest professionals in the
addiction field regardless of their political persuasion.
The director, Dr Jerry Jaffe, was one of the brightest and
most inspiring people with whom I have worked. He never
talked much about his political views but I think at heart
he was Democrat. Jaffe had a clear vision of the way he felt
heroin abuse could effectively be controlled in the country.
I learned from him to think strategically and on a very big
national or global scale. His deputy, Paul Perito, was a
partisan Democrat who had previously been a legislative
assistant to a Democratic member of Congress and had been
instrumental in drafting the legislation that created SAODAP.
Following Nixon inaugural celebrations for his second term
Perito resigned to go into private law practise. As the
senior Assistant Director I would have been the natural
choice to succeed him. However, the bipartisanship of the
Nixon administration did not extend that far. The Deputy’s
position required Senate confirmation and with the Watergate
battle beginning they did not want to nominate again someone
as overtly Democratic as I. I was very happy with the
decision because although I could tell no one in Washington
the last thing I needed with my Carter colleagues was to
become a Nixon Presidetial appointee approved by the Senate.
For the rest of my time at SAODAP the Deputy position
remained unfilled which was ideal for me. I functioned in
that role without the burden of the Nixon imprimatur. As the
Watergate scandal grew drug abuse shrank to a low level on
the White House agenda. Several of SAODAP’s early advocates
such as Bud Krogh,
and John Erlichman would be indicted and later go to jail.
Jerry Jaffe eventually resigned and his place was taken by
my friend Bob DuPont.
Throughout my time at SAODAP I had flown, more or less
secretly, back to Atlanta every other weekend to work with
Carter and others on his incipient Presidential campaign. In
August of 1974 I resigned from SAODAP to begin publicly
organizing the Carter campaign office in Washington in
preparation for the formal announcement of his candidacy on
December 12th of that year. I also became a fellow at the
Drug Abuse Council, a non-profit, foundation supported,
think tank focusing on drug abuse issues. Its president was
a medical school classmate of mine Dr Tom Bryant who had
also acquired a law degree. He had been the director of the
Office of Health Affairs in Lyndon Johnson’s Office of
Economic Opportunity (“War of Poverty”). I wrote and
published several papers on different aspects of the drug
problem and simultaneously devoted an increasing amount of
my time to the Carter initiative. Because of my
international activities while at SAODAP I received several
contracts from the State Department and other organizations
to attend international meetings on drug abuse and to serve
as consultant visiting mainly countries in Asia. It began a
long series of visits to Burma and to Iraq where I had
meetings with several of the top government officials
arranged for me by Sen. William Fullbright. I also had a
small grant from the state of Wyoming to assess the extent
of addiction there. I used my several trips to the state to
recruit a small following for a Carter presidency.
During the Ford administration the legislation creating
SAODAP expired. Congress quickly passed a new bill creating
the Office of Drug Abuse Policy (ODAP). Members of Congress
wanted to maintain some momentum in the drug abuse area, but
many also liked the idea of having a significant policy
making entity in the Office of the President with a senate
confirmed director that they could call to testify before
the committees in both houses. Normally anyone working
directly for the president could avoid testifying before
Congress by claiming executive privilege. In order to get
bipartisan support for SAODAP Nixon had made an
extraordinary concession in allowing a component of his
executive office to be subject to such direct oversight by
the Congress. SAODAP, although it had sweeping authority,
had exercised it only for the demand (or treatment) side.
The new legislation creating ODAP gave it authority over all
aspects of the drug abuse problem, law enforcement, foreign
policy, the military and treatment. Ford signed the
legislation but never implemented it. Why not is uncertain .
Whether, as a former congressional leader, he understood the
danger of allowing congress to intrude into the executive
power of the president, or whether he was just too
pre-occupied with other priorities such as the fall-out from
the Nixon pardon or his own campaign to run for re-election
is unclear.
When Carter was elected I found myself in a difficult
quandary. I was appointed as a special assistant to the
president and as one of the eight staff people in the White
House reporting directly to the President. My first major
undertaking was to put together a presidential commission on
mental health and mental illness which was going to be
Rosalynn Carter’s main initiative. Also, beginning during
the transition, I had prepared for the president a 100-page
document on SAODAP, ODAP and the question of drug abuse
policy in the new administration. I did not particularly
want to be the director of ODAP as I wanted a mandate much
larger than just the drug issue. On the other hand my role
was poorly circumscribed and I knew I would have to scramble
all the time to justify my presence in the White House just
as a special assistant. As director of ODAP I would have a
clear legislated mandate and a position that was
Senate-confirmed. The ODAP role, unlike SAODAP, included
authority over not just the “demand side” (treatment) but
also over law enforcement and foreign policy as well. At
SAODAP it had always been frustrating, despite the
significant power the office wielded, to have people at the
Drug Enforcement Administration or the State Department
pursuing their own policies which were often at odds with
what I was trying to accomplish. As head of ODAP I would
have policy control over the entire drug abuse issue
throughout the federal government. In addition I was
arrogant enough to believe that there was no one else who
was better prepared or could do the job better than I. If I
did not take the job I would have to come up with the name
of someone else to do it. I knew that whoever that might be
I would find it very frustrating not to have control over
this area, particularly if I was losing out in the power
struggles in the White House.
Carter was happy to nominate me for the job and also agreed
to my having a dual role with an additional title as special
assistant for health issues. This allowed me to stay in a
vital position in the administration’s effort to develop
national health insurance. This involved especially working
with Sen. Ted Kennedy and other key members of Congress.
Also over time I became the point person in the White House
dealing with United Nations humanitarian issues such as
international health, world hunger, and emergency relief. I
put together a presidential commission on Hunger and
Malnutrition as well as a Commission on the International
Year of the Child. I also directed a study of all
international health programs in the US government that
resulted in the publication of a definitive report. I was
also the point person for the White House Fellows program
serving on the commission that picked the fellows each year.
The only problem with this dual role was that I was
stretched extremely thinly and was always buried in work.
My nomination to be director of ODAP was well received in
the Senate with the exception of Sen Orin Hatch of Utah. He
was a very conservative and xenophobic Mormon. I had the
sense that he opposed me more than anything because I had
not been born in the US. I was nevertheless confirmed by 98
votes to one.
I came into the job with a pretty clear idea of what I
wanted to do. I approached the drug abuse issue as a public
health problem in which the primary objective was to reduce
the harm that the use of drugs caused people. I made a point
whenever I spoke in public about the adverse health effects
of drugs of always saying “drugs including alcohol and
tobacco...” My goal, as I saw it, was to bring the number of
drug related deaths, from both legal and illegal sources, as
low as possible and to minimize the overall harm that drug
use inflicted on society and the individual. I believed that
a long prison term could do far more to destroy the life of
a drug user than the drug he or she was convicted of using.
I wanted to continue the policy established by Jerry Jaffe
that sought to guarantee access to treatment for every
addict who wanted it. I was also committed to restricting
the availability of drugs at the source through
international collaboration. I also believed that law
enforcement was critical but primarily when it focused on
major traffickers rather than street level dealers. I also
thought that pharmaceutical companies had a major
responsibility in curtailing the abuse of their products.
Peter Benzinger had been appointed head of the Drug
Enforcement Administration by President Ford. He was someone
I knew well, respected and liked.. I re-appointed him to the
position. Today keeping on someone from the other party
would be almost unthinkable. My friend Bob DuPont was by
then the director of the National Institute for Drug Abuse.
I arranged for my friend Mathea Falco, a lawyer and former
congressional staffer with wide experience in drug abuse to
become the Assistant Secretary of State for Narcotic Affairs
at the State Department. Robert Chasen was the Commissioner
of Customs. I appointed as my deputy Lee Dogoloff who had
been Bob DuPont’s deputy at the DC Narcotic Treatment
Administration. We met, as a team referred to as “the
principals group,” very Monday for an hour to compare notes
and plan the national strategy. (The Commandant of the Coast
Guard would also attend periodically).
I spent a great deal of my time testifying before Congress.
Drug abuse was a high profile issue and members saw it as an
easy way to grab headlines and raise their profile.
Congressman Lester Wolfe was chairman of both the House
Select Committee on Narcotics and of the Asia sub-committee
of the House Foreign Relations Committee. His Republican
counter-part, Cong. Ben Gilman, someone I greatly liked,
shared his enthusiasm for travel and interest in the
narcotics issue. They made regular trips to South East Asia
where on one occasion Cong. Wolfe met with the drug lord
Khun Sa. He negotiated a deal whereby, in return for $35
million from the US government Khun Sa would undertake to
stop all heroin coming out of Burma. It was an absurd
proposition as it was something Khun Sa could not hope to
deliver on not to mention that he was leading an insurgent
group pitted against the government of Burma with which the
US had diplomatic relations and a cordial dialogue at that
time. Before the Congress and in the media Cong. Wolfe
played the issue for all it was worth dragging before
countless hearings and berating me for not accepting this
“wonderful offer.” It did, however, establish the basis upon
which I was able to go, several years later, to the Shan
State and meet with Khun Sa myself. (Report on the visit to
Shan State.)
During my time as Director of ODAP I achieved a number of
success of which I felt proud.
• Under my tenure we brought the number of people dying in
the US from heroin overdoses down to its lowest level in 30
years (around 800 per year).
• Working with the pharmaceutical industry I negotiated a
voluntary code to restrict the use of barbiturates to
hospital settings. This included a special exception for
rare forms of epilepsy that could only be controlled by
these drugs. The result was dramatic decline in the
availability of barbiturates on the street and a significant
drop in overdose deaths attributable to them. Although the
industry had no particular problem with the arrangement the
Reagan administration cancelled it on the grounds that it
was an unwarranted restriction on private industry. The
result was more people died.
• I negotiated effective drug control policies with the
governments of the source countries Thailand, Burma, Mexico,
and Columbia providing them with financial assistance and
aircraft including helicopters to Burma and Mexico. I also
devoted considerable time to coordinating US drug policy
with my counterparts in European nations.
• Deciding that the best way to track major dealers was
through their money rather than chasing the drugs they moved
I had the Justice and Treasury Departments institute a
process whereby all banks had to file a form with the
Federal government whenever they received a cash deposit of
$10,000 or more.
• I down played the issue of marijuana from which
essentially no one died and which posed, compared to other
illicit drugs not to mention alcohol and cigarettes, a very
modest public health threat. Because of the wide difference
in attitudes around the country (Alaska wanted to legalize,
the Southern States to maintain harsh penalties) I
established the policy that the individual states should set
their own penalty levels for possession and sale.
• I expanded nationwide the availability of treatment
programs and increased the funding for prevention programs
especially those that were community based.
• I worked with the military leadership to up grade the
treatment of those serving in the armed forces.
• Most importantly I maintained the basic policy position of
the US government that drug abuse was primarily a public
health problem. This policy was overturned by Reagan as soon
as he came into office. Drug dependence, he decreed, would
no longer be viewed as a health issue but as a moral and
criminal problem. Immediately deaths began to climb and the
numbers in prison on drug related charges soared.
In July 1978 I became aware that one of my staff members was
having personal problems causing emotional distress that was
interfering with her work. She had recently had an abortion.
Late one evening we had a frank discussion during which I
suggested that she seek professional help and offered to
refer her to a psychologist friend of mine. She was
reluctant to do this, in part, because having previously
been a staff member of the House Intelligence Committee she
was worried that any record of having seen a psychiatrist or
psychologist might put her security clearance in jeopardy.
“Besides” she said “My main problem is just having
difficulty sleeping.” I offered to write her a prescription
for sleeping medication and to further allay her concerns
about confidentiality agreed to use a pseudonym in place of
her real name (a fairly standard practice with people in
prominent positions). My only dilemma at the time was what
drug to use. A barbiturate would have been the natural
choice, but being in the middle of a campaign to end the
prescribing of that category of drug on an out-patient basis
I felt I could not be on record as having done so myself. I
quickly settled on Methaqualone, a non-narcotic sedative
that was widely popular with 25 million prescriptions
written for it a year. It had some reputation as drug of
abuse, but that was true for virtually every prescribed
psychoactive drug.
My assistant took the prescription home that evening and
asked her room-mate, a physical therapist, to get it filled
for her at a pharmacy near to where she would be working the
next morning in Manassas, Virginia. The pharmacist asked the
room-mate if the prescription was for her. She said ‘no’ it
was for her room-mate. “What is the name of your room-mate?”
the pharmacist asked. The name she gave was, of course
different from the pseudonym on the prescription, a
discrepancy she attempted to explain. By sheer coincidence a
state pharmacy inspector happened to be in the drug store at
the time and the pharmacist involved him in the discussion.
When it emerged that I, the writer of the prescription,
worked n the White House it spurred phone calls up the
regulatory, political and judicial system of the state of
Virginia. system. I suddenly found myself engulfed in a
maelstrom of press stories, innuendoes and out-right lies.
When you are in a prominent position it is amazing how much
jealousy and hostility you engender. It seemed every enemy I
had ever made was out to get even with me including sveral
of my colleagues in the White House. A new story emerged
alleging that several months earlier I had been at a party
hosted by the son of the president of CBS television at
which cocaine was used and that I probably was a
participant. The first part of the story was true but not
the second. The media conveniently ignored the fact that my
assistant took and passed a lie detector test in which she
was asked if she ever had any intention of using the drug I
prescribed for anything other than legitimate medical
purposes. There was no suggestion that a special prosecutor
should be appointed as would occur later in the Carter
presidency when questionable conduct by other White House
staff was alleged. In the end no charges were filed against
me or my assistant. However, the political hysteria had
become such a distractio for the White House that I decided
out of loyalty to President Carter that I should resign.
I would move on to an appointment at the United Nations
which kept me busy with other issues, but over the years I
have continued to stay involved with drug abuse and
alcoholism.
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