Copyright 1999 Federal Document Clearing House, Inc.
Federal Document Clearing House Congressional Testimony
October 21, 1999
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 2480 words
HEADLINE:
TESTIMONY October 21, 1999 JOHN L. MICA CHAIRMAN SENATE
GOVERNMENT REFORM CRIMINAL JUSTICE, DRUG POLICY AND HUMAN RESOURCES MEDICAL
TREATMENT FOR SUBSTANCE ABUSERS
BODY:
"Substance
Abuse Parity: HENRY A WAXMAN. CALIFORNIA. RANKING MINORITY
MEMBER A Viable Solution to the Nation's Epidemic of Addiction?" OPENING
STATEMENT Chairman John L. Mica Subcommittee on Criminal Justice, Drug Policy
and Human Resources October 21, 1999 Hearing: The Subcommittee on Criminal
Justice, Drug Policy and Human Resources convenes today to discuss our country's
war on drugs from a perspective that is different from that of previous
hearings. Recently, we have held a number of hearings on topics that impact the
supply of drugs in our nation. Our hearings have ranged from international
narco-terrorism developments in Colombia, to interdiction operations and
resource needs across our southwest border. Last week, we held an important and
insightful hearing on what is being done through our now federally-funded media
campaign to reduce the demand for drugs. Today, we will examine another
important component of our national efforts to reduce the demand for drugs. We
will focus on drug treatment and funding options that might be affordable and
make a difference in the drug war. Treatment generally receives less coverage in
the press, and is often misunderstood. We will examine carefully how treatment
might be used to reduce drug- related deaths and ' destruction. Today, we will
hear more about the positive consequences of successfully treating drug abuse.
We are especially grateful to our witness who has come forward to tell us of
about her personal experiences. Her testimony will illustrate how some persons
with alcohol and illicit drug addictions have broken those terrible chains and
regained control of their lives. We all agree that the number of such positive
outcomes from addiction should be increased to the greatest extent possible.
Accordingly, drug treatment benefits and funding options deserve our close
attention. Since 1996, Congress increased federal spending from $13 billion to
almost $17.8 billion for drug control programs and activities. Most of this
increased funding has been targeted toward reducing demand. Twenty-six (26%) of
the $4 billion increase was set aside for improving treatment options. However,
despite the commitment of more dollars and an emphasis on treatment and reducing
the demand for drugs, alarming trends demonstrate the need further action. We
know, for example, that from 1993 to 1997, the number of Americans reporting
heroin use rose from 68,000 to 325,000 -- more than quadrupling! With an
estimated 26 million Americans addicted to drugs and alcohol, the human toll is
ever present. In mid-August, drugs claimed the life of a young thirteen year-old
in central Florida. The soon to be eighth grader, Jonathan Hilaire, died of a
cocaine overdose while visiting Disney World in Orlando. How can this happen?
What can be done to save these young lives? I think we can all agree that more
action is needed. In fact, combating substance abuse requires the best efforts
of our federal, state and local governments; our families and communities; our
social and religious institutions; and our employers and private sector
businesses. In recent years, some observers have adopted the view that drug
addiction should be considered as a brain disease, because of accompanying
biological changes that occur in the brain. Others argue that addiction is
primarily a behavioral disorder, often as the result of personal or character
weaknesses over which individuals can and should exercise personal control.
These differing views also must factor in the realization that we expect the
criminal justice system to respond to drug-related crimes -- and to encourage
law-abiding behaviors. This responsibility often includes the treatment of
offenders for drug addictions. Numerous studies indicate that the longer a
person stays in a treatment program, the better the outcome will be. Treatment
options enforceable under the law provide added leverage to ensure an abuser's
participation. Today, we will discuss options for including substance abuse
treatment in employee health plans. Too often, we stereotype
drug addicts as being people unable to hold down regular jobs. A Bureau of Labor
Statistics report released earlier this year reports that more than 70% of those
using illicit drugs and 75% of alcoholics do in fact hold down regular jobs.
This represents a significant portion 6f the country's substance abusers. Many
of these employees have, or may acquire, access to some form of employer
provided healthcare coverage. Today, it has been estimated that only about 2% of
substance abusers are fortunate enough to be covered by health
plans that provide for adequate treatment. I recognize that a handful of states
already have passed legislation that includes substance abuse
parity provisions. I also fully realize that unwise federal
mandates can disrupt markets, cause inefficiencies and have other unintended
negative consequences. For these reasons, any new federal mandates should be
considered only under exceptional circumstances of demonstrated need. In light
of the impact of drugs on our lives and livelihood, we must consider all
appropriate and promising measures. If affordable and effective, employee access
to substance abuse treatment through employee health plans
might be a viable weapon in reducing the demand for drugs in this country. The
National Institute on Drug Abuse (NIDA) estimates that drug treatment reduces
use by 40 to 60 percent, and significantly decreases criminal activity after
treatment. In addition to preventing human misery, promoting substance abuse
treatment potentially could have significant economic benefits. The costs of
both drug and alcohol addiction to society -- including costs for
health care, substance abuse prevention, treatment for
addiction, combating substance-related crimes, and lost resources resulting from
reduced worker productivity and deaths -- are enormous. Estimates range from $67
billion annually up to $246 billion -- almost a quarter trillion dollars!
(Sources: GAO; NIDA) The Substance Abuse and Mental Health
Administration (SAMHSA) claims that dollars spent on substance abuse treatment
can have tremendous savings -- saving society as much as $4 to $7 for each
dollar that is wisely invested in effective drug treatment. If accurate,
spending a comparatively small percentage of our business dollars for prevention
and treatment -- an amount less than what would be needed to recoup the costs of
lost productivity due to addictions -- might be a wise and cost-effective
investment. Legislative proposals for providing substance abuse treatment in
employee health plans have taken varying approaches. The
different proposals introduced in this Congress focus on providing insurance
benefits for substance abuse treatment that are equal to benefits for other
provided medical and surgical care. While these bills promote access to
substance abuse treatment through employee health plans,
consensus has not been reached regarding the scope of coverage and the cost that
employees and employers must bear. The panels of witnesses before us this
morning will discuss treatment successes, studies, legislative proposals and
possible treatment payment options. In some instances, comparisons will be made
to the Mental Health Parity Act of 1996, and how that law has
impacted employers, insurers, treatment providers, participants and others. The
Act imposed a national minimum benefit standard for mental
health benefits on employer- sponsored health
insurance for the first time. Key questions we must consider are whether the
approach taken with mental health treatment benefits is
working, and whether this approach is fully applicable to alcohol and substance
abuse treatment benefits. Our first two panelists are respected members of
Congress -- one from the U. S. Senate, and the other a fellow colleague of ours
in the House. Each has worked long and hard to promote substance abuse treatment
parity at a national level. We look forward to hearing their
thoughts and proposals on the subject. The panelist on our second panel has
graciously agreed to come and share her personal story of addiction. Her remarks
will serve to enlighten us about the difficulties faced by those who struggle to
overcome substance abuse. Our third panel is made up of experts from the field
who will discuss costs and benefits of treatment, and their ideas and concerns
regarding substance abuse treatment parity in healthcare plans.
These officials, experts and persons with first-hand knowledge of addiction and
treatment will give us a better understanding of this critical issue, and how we
might promote effective substance abuse treatment in our war on drugs. We look
forward to hearing this testimony.
LOAD-DATE: October
27, 1999 
