[House Hearing, 113 Congress]
[From the U.S. Government Publishing Office]
METHAMPHETAMINE ADDICTION:
USING SCIENCE TO EXPLORE SOLUTIONS
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON RESEARCH AND TECHNOLOGY
COMMITTEE ON SCIENCE, SPACE, AND TECHNOLOGY
HOUSE OF REPRESENTATIVES
ONE HUNDRED THIRTEENTH CONGRESS
FIRST SESSION
__________
SEPTEMBER 18, 2013
__________
Serial No. 113-48
__________
Printed for the use of the Committee on Science, Space, and Technology
Available via the World Wide Web: http://science.house.gov
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COMMITTEE ON SCIENCE, SPACE, AND TECHNOLOGY
HON. LAMAR S. SMITH, Texas, Chair
DANA ROHRABACHER, California EDDIE BERNICE JOHNSON, Texas
RALPH M. HALL, Texas ZOE LOFGREN, California
F. JAMES SENSENBRENNER, JR., DANIEL LIPINSKI, Illinois
Wisconsin DONNA F. EDWARDS, Maryland
FRANK D. LUCAS, Oklahoma FREDERICA S. WILSON, Florida
RANDY NEUGEBAUER, Texas SUZANNE BONAMICI, Oregon
MICHAEL T. McCAUL, Texas ERIC SWALWELL, California
PAUL C. BROUN, Georgia DAN MAFFEI, New York
STEVEN M. PALAZZO, Mississippi ALAN GRAYSON, Florida
MO BROOKS, Alabama JOSEPH KENNEDY III, Massachusetts
RANDY HULTGREN, Illinois SCOTT PETERS, California
LARRY BUCSHON, Indiana DEREK KILMER, Washington
STEVE STOCKMAN, Texas AMI BERA, California
BILL POSEY, Florida ELIZABETH ESTY, Connecticut
CYNTHIA LUMMIS, Wyoming MARC VEASEY, Texas
DAVID SCHWEIKERT, Arizona JULIA BROWNLEY, California
THOMAS MASSIE, Kentucky MARK TAKANO, California
KEVIN CRAMER, North Dakota ROBIN KELLY, Illinois
JIM BRIDENSTINE, Oklahoma
RANDY WEBER, Texas
CHRIS STEWART, Utah
VACANCY
------
Subcommittee on Research and Technology
HON. LARRY BUCSHON, Indiana, Chair
STEVEN M. PALAZZO, Mississippi DANIEL LIPINSKI, Illinois
MO BROOKS, Alabama FEDERICA WILSON, Florida
RANDY HULTGREN, Illinois ZOE LOFGREN, California
STEVE STOCKMAN, Texas SCOTT PETERS, California
CYNTHIA LUMMIS, Wyoming AMI BERA, California
DAVID SCHWEIKERT, Arizona DEREK KILMER, Washington
THOMAS MASSIE, Kentucky ELIZABETH ESTY, Connecticut
JIM BRIDENSTINE, Oklahoma ROBIN KELLY, Illinois
LAMAR S. SMITH, Texas EDDIE BERNICE JOHNSON, Texas
C O N T E N T S
September 18, 2013
Page
Witness List..................................................... 2
Hearing Charter.................................................. 3
Opening Statements
Statement by Representative Larry Bucshon, Chairman, Subcommittee
on Research and Technology, Committee on Science, Space, and
Technology, U.S. House of Representatives...................... 6
Written Statement............................................ 7
Statement by Representative Daniel Lipinski, Ranking Minority
Member, Subcommittee on Research and Technology, Committee on
Science, Space, and Technology, U.S. House of Representatives.. 8
Written Statement............................................ 9
Statement by Representative Lamar S. Smith, Chairman, Committee
on Science, Space, and Technology, U.S. House of
Representatives................................................ 10
Written Statement............................................ 11
Statement by Representative Eddie Bernice Johnson, Ranking
Member, Committee on Science, Space, and Technology, U.S. House
of Representatives............................................. 12
Written Statement............................................ 12
Witnesses:
Ms. Niki Crawford, First Sergeant, Meth Suppression Section
Commander, Indiana State Police
Oral Statement............................................... 13
Written Statement............................................ 16
Dr. Edythe London, The Thomas and Katherine Pike Professor of
Addiction Studies, Director of the UCLA Laboratory of Molecular
Neuroimaging at the David Geffen School of Medicine, University
of California at Los Angeles
Oral Statement............................................... 26
Written Statement............................................ 28
Dr. Jane Maxwell, Senior Research Scientist, School of Social
Work, University of Texas at Austin
Oral Statement............................................... 49
Written Statement............................................ 51
Dr. Celeste Napier, Director, Center for Compulsive Behavior and
Addiction, Professor of Pharmacology and Psychiatry, Rush
University Medical Center, Chicago,
Oral Statement............................................... 65
Written Statement............................................ 67
Discussion....................................................... 72
Appendix I: Answers to Post-Hearing Questions
Dr. Edythe London, The Thomas and Katherine Pike Professor of
Addiction Studies, Director of the UCLA Laboratory of Molecular
Neuroimaging at the David Geffen School of Medicine, University
of California at Los Angeles................................... 86
Dr. Jane Maxwell, Senior Research Scientist, School of Social
Work, University of Texas at Austin............................ 91
Dr. Celeste Napier, Director, Center for Compulsive Behavior and
Addiction, Professor of Pharmacology and Psychiatry, Rush
University Medical Center, Chicago, Illinois................... 94
METHAMPHETAMINE ADDICTION: USING SCIENCE TO EXPLORE SOLUTIONS
----------
TUESDAY, SEPTEMBER 18, 2013
House of Representatives,
Subcommittee on Research and Technology
Committee on Science, Space, and Technology,
Washington, D.C.
The Subcommittee met, pursuant to call, at 10:09 a.m., in
Room 2318 of the Rayburn House Office Building, Hon. Larry
Bucshon [Chairman of the Subcommittee] presiding.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Chairman Bucshon. The Subcommittee on Research and
Technology will come to order. Good afternoon. Good morning.
Welcome to today's hearing titled ``Methamphetamine Addiction:
Using Science to Explore Solutions.'' In front of you are
packets containing the written testimony, biographies, and
truth-in-testimony disclosures for today's witnesses. I
recognize myself for five minutes now for an opening statement.
I would like to welcome everyone to today's Research and
Technology Subcommittee hearing titled, ``Methamphetamine
Addiction: Using Science to Explore Solutions.''
The problem of methamphetamine, or meth, abuse is a serious
problem facing our country today. The main compound from which
meth derives is pseudoephedrine, known as PSE, which is also a
common drug used to treat nasal and sinus congestion.
Unfortunately, criminal dealers have discovered new, easier
ways to make more potent forms of meth that require the use of
chemicals such as PSE.
As our witnesses will testify today, meth poses significant
public safety and health risks, in addition to financial
burdens to local communities where these toxic and dangerous
labs are found.
According to a 2013 Government Accountability Office report
titled ``State Approaches Taken to Control Access to Key
Methamphetamine Ingredient Show Varied Impact on Domestic Drug
Labs,'' the number of meth lab incidents declined significantly
after 2004, when state and Federal regulations on PSE product
sales were implemented. Since 2007, however, these numbers have
significantly increased, reflecting the emergence of smaller-
scale production facilities by a new method called smurfing,
where individuals purchase the legal limits of PSE at multiple
stores that are then combined for meth drug production. They
also buy it from multiple other people, including in some
reports college students are--who are getting extra money by
selling these products at a higher cost than they can buy them
for.
But more than figures and statistics, meth addiction is a
problem that personally hits home for many Americans. As a
medical doctor, I personally know the devastation that
addiction can cause and even after meth addicts kick the habit,
some research shows these addicts experience permanent damage,
similar to what LSD may have caused back in the '60s and '70s.
From January to July of this year, over 65 meth labs have
been dismantled in the biggest county in my district,
Vanderburgh County, making it the number one county for meth
labs in the state of Indiana. This is extremely close to my
home next door in Warrick County where we have had two meth lab
explosions within a two-mile radius of my house. In November
2011, a meth lab exploded down the street from my house in a
middle-class neighborhood burning down that house and causing
over $25,000 in damage to surrounding middle-class homes. This
is not a problem that is only isolated to certain areas of our
communities.
Despite the grim realities of meth addiction, science can
provide valuable insights to this problem. Basic science
agencies like the National Institutes of Health have spent over
$68 million in Fiscal Year 2013 to understand the neurological
basis of meth addiction. The National Science Foundation also
supports fundamental nonmedical basic science research, in
particular behavioral research, behind the psychology of
addiction.
Our witnesses today reflect the wide spectrum of work and
research regarding the various facets of the meth problem.
Witnesses will introduce the extent of the meth problem and
will discuss a wide range of topics on how science can help us
understand the prevention and treatment of meth, as well as how
technology can be used to stop unauthorized purchases of PSE.
I would like to thank all of our witnesses for being here
today and taking the time to offer their perspectives on this
critical topic for our communities. I would also thank Ranking
Member Lipinski and everyone else for participating in today's
hearing.
[The prepared statement of Mr. Bucshon follows:]
Prepared Statement of Subcommittee on Research and Technology Chairman
Larry Bucshon
I would like to welcome everyone to today's Research and Technology
Subcommittee hearing titled ``Methamphetamine Addiction: Using Science
to Explore Solutions.''
The problem of methamphetamine, or meth, abuse is a serious problem
facing our country today. The main compound from which meth derives is
pseudoephedrine, known as PSE, which is also a common drug used to
treat nasal and sinus congestion. Unfortunately, criminal dealers have
discovered new, easier ways to make more potent forms of meth that
require the use of chemicals such as PSE. As our witnesses will testify
today, meth poses significant public safety and health risks, in
addition to financial burdens to local communities where these toxic
and dangerous labs are found.
According to a 2013 Government Accountability Office report titled
``State Approaches Taken to Control Access to Key Methamphetamine
Ingredient Show Varied Impact on Domestic Drug Labs,'' the number of
meth lab incidents declined significantly after 2004 when state and
federal regulations on PSE product sales were implemented. Since 2007,
however, these numbers have significantly increased, reflecting the
emergence of smaller-scale production facilitated by a new method
called smurfing, where individuals purchase the legal limits of PSE at
multiple stores that are then combined for meth drug production.
But more than figures and statistics, meth addiction is a problem
that personally hits home for many Americans. As a medical doctor and
physician, I personally know the devastation that addiction can cause
and even after meth addicts kick their habit, research shows these
addicts experience permanent damage. From January to July of this year,
over 65 meth labs have been dismantled in the biggest county in my
district, Vanderburgh County, making it the number one county for meth
labs in the state. This is extremely close to my home next door in
Warrick County and where we have had two meth lab explosions within a
2-mile radius of my house. In November of 2011, a meth lab exploded
down the street from my house burning a house to the ground and causing
over $25,000 in damage to houses around it.
Despite the grim realities of meth addiction, science can provide
valuable insights to this problem. Basic science agencies like the
National Institutes of Health have spent over $68 million in FY 2013 to
understand the neurological basis of meth addiction. NSF also supports
fundamental non-medical basic science research, in particular
behavioral research behind the psychology of addiction.
Our witnesses today reflect the wide spectrum of work and research
regarding the various facets of the meth problem. Witnesses will
introduce the extent of the meth problem, and will discuss a wide range
of topics on how science can help us understand the prevention and
treatment of meth as well as how technology can be used to stop
unauthorized purchases of PSE.
I would like to thank the witnesses for being here today and taking
time to offer their perspectives on this critical topic for our
communities. I'd also like to thank Ranking Member Lipinski and
everyone else participating in today's hearing.
Chairman Bucshon. At this point I will now recognize the
Ranking Member of the Subcommittee, the gentleman from
Illinois, Mr. Lipinski, for his opening statement.
Mr. Lipinski. Thank you. I want to thank you, Mr. Chairman,
for holding this hearing and thank our witnesses for being here
this morning.
As a Representative from the state of Illinois, I am very
interested in this topic because my state experienced some of
the same meth abuse problems as Chairman Bucshon's district and
state. Geographically, Illinois sits right in the center of the
top five states in the country for number of clandestine meth
lab incidents reported in 2012. With 801, it had the 5th-
highest number of lab incidents.
My colleagues in districts affected by heavy meth abuse, as
well as my colleagues in districts affected by other illegal
drugs, understand the heavy burden placed not only on families
but also the local economy, hospitals, law enforcement, and the
court system. Unfortunately, if the sequester continues,
Illinois will lose about $3.5 million in grants to help prevent
and treat substance abuse resulting in around 3,900 fewer
admissions to substance abuse programs.
Congress and individual states have developed laws aimed at
making the precursor chemicals for methamphetamine harder to
purchase, as the Chairman stated, but there is still more work
to be done. In order to do our jobs and craft effective
policies to combat meth addiction, we need to know more about
the science behind addiction and effective prevention and
treatment programs.
Much of the research you will hear about this morning is
funded by the National Institute on Drug Abuse at the National
Institutes of Health, which unfortunately is not in our
Committee's jurisdiction. But, I hope today we also have the
opportunity to explore the types of foundational social and
behavioral research, as well as the neuroscience research, that
underlies much of the more application-driven research that is
the purview of several of our witnesses today. As Dr. Gene
Robinson testified at the BRAIN Initiative hearing in July, it
is necessary to understand how healthy brains work from both a
functional and behavioral perspective in order to cure the main
devastating brain disorders that afflict our society. This is
the type of science championed by NSF. Because of the important
work already supported by both NSF and NIDA, our society is
starting to accept addiction as a disease of the brain
influenced by environmental factors.
Many people addicted to drugs trace their problem back to
their school years and acting out teenage curiosity. Thus, to
meaningfully change this trend, our conversation must also
include teen behavior and drug use and how we might use the
education system and public education campaigns as vehicles for
prevention. Unless we apply what we know about a teenager's
brain and behavior to design such education efforts, and change
course as we learn more, we may be setting ourselves up to
fail.
I look forward to Dr. Napier's testimony on her work
studying the adolescent brain and supporting school-based
curricula to help kids build good decision-making skills. These
are the very skills they need to keep themselves out of the
penal system where they are often introduced to a network of
drug dealers within their communities, making the likelihood of
relapse after release from jail very high.
Social networks and markets for meth are also important
topics for research that can inform the development of more
effective prevention policies. For example, we know that meth
abuse often circulates within families among close
acquaintances. Additionally, as I understand it, whereas meth
labs used to be typically in a room or basement of a home, a 2-
liter shake-and-bake bottle can now be quickly improvised in
the backseat of a car or behind a dumpster in the schoolyard.
We also know that meth is more successful in penetrating
some markets than others. Identifying and understanding the
factors behind the meth market and how meth abuse spreads in
social networks is a challenge that requires collaboration
among social scientists and law enforcement officials.
Finally, evidence-based policymaking is essential for
effective treatment. If meth addicts are only fixated on their
next high as the research has shown, then the standard 12-step
program will not be an effective treatment tool for them.
Treatment programs for meth addiction have evolved based on our
increased understanding of what works and what doesn't, but
more progress is still needed. As a social scientist myself, I
find all of these to be interesting, compelling research
challenges.
Before I close, I would like to mention that a bipartisan
law was passed through our Committee in 2007 that addressed
meth, specifically with a focus on a lack of national standards
for remediation of meth labs. For every pound of meth produced,
five to six pounds of toxic byproducts remain in walls and
carpets, as well as ventilation and wastewater systems. Perhaps
it is worth this Subcommittee, through its jurisdiction over
NIST, reviewing where we now stand with respect to remediation
standards. I think this is an area in which we can work again
on a bipartisan basis for the health of our first responders
who investigate meth labs and citizens in those communities.
Again, I look forward to hearing testimony from the
witnesses and hope the testimony can get us thinking about how
research can help us better tackle the increasing meth
addiction problem plaguing our communities.
I yield back the balance of my time.
[The prepared statement of Mr. Lipinski follows:]
Prepared Statement of Subcommittee on Research and Technology
Ranking Minority Member Daniel Lipinski
Mr. Chairman, thank you for holding this hearing and thank you to
our witnesses for being here this morning.
As a Representative from the state of Illinois, I am very
interested in this topic because my state is experiencing some of the
same meth abuse problems as Chairman Bucshon's district and state.
Geographically, Illinois sits right in the center of the top five
states in the country for number of clandestine meth lab incidents
reported in 2012. With 801, it had the fifth highest number of lab
incidents. My colleagues in districts affected by heavy meth abuse, as
well as my colleagues in districts affected by other illegal drugs,
understand the heavy burden placed not only on families, but also the
local economy, hospitals, law enforcement, and the court system.
Unfortunately, if the sequester continues Illinois will lose about $3.5
million in grants to help prevent and treat substance abuse, resulting
in around 3,900 fewer admissions to substance abuse programs.
Congress and individual states have developed laws aimed at making
the precursor chemicals for methamphetamine harder to purchase, but
there is still work to be done. In order to do our jobs and craft
effective policy to combat meth addiction, we need to know more about
the science behind addiction and effective prevention and treatment
programs.
Much of the research we will hear about this morning is funded by
the National Institute on Drug Abuse at the National Institutes of
Health, which unfortunately is not in this Committee's jurisdiction.
But I hope today we also have an opportunity to explore the types of
foundational social and behavioral research, as well as the
neuroscience research, that underlies much of the more application-
driven research that is the purview of several of our witnesses today.
As Dr. Gene Robinson testified at the Brain Initiative Hearing in July,
it is necessary to understand how healthy brains work, from both a
functional and behavioral perspective, in order to cure the many
devastating brain disorders that afflict our society. This is the type
of science championed by NSF. Because of the important work already
supported by both NSF and NIDA, our society is starting to accept
addiction as a disease of the brain influenced by environmental
factors.
Many people addicted to drugs trace their problem back to their
school years and acting out teenage curiosity. Thus to meaningfully
change this trend, our conversation must also include teen behavior and
drug use, and how we might use the education system and public
education campaigns as vehicles for prevention. Unless we apply what we
know about the teenager's brain and behavior to the design of such
education efforts, and change course as we learn more, we may be
setting ourselves up to fail.
I look forward to Dr. Napier's testimony on her work studying the
adolescent brain and supporting school-based curricula to help kids
build good decision-making skills. These are the very skills they need
to keep themselves out of the penal system where they are often
introduced to a network of drug dealers within their communities making
the likelihood of a relapse after release from jail very high.
Social networks and markets for meth are also important topics for
research that can inform the development of more effective prevention
policies. For example, we know that meth abuse often circulates within
families and among close acquaintances. Additionally, as I understand
it, whereas meth labs used to be typically in a room or basement of a
home, a 2-liter ``shake and bake'' bottle can now be quickly improvised
in the back seat of a car or behind the dumpster in a school yard. We
also know that meth is more successful in penetrating some markets than
others. Identifying and understanding the factors behind the meth
market and how meth abuse spreads in social networks is a challenge
that requires collaboration among social scientists and law enforcement
officials.
Finally, evidence-based policy making is essential for effective
treatment. If meth addicts are only fixated on their next high, as
research has shown, then the standard 12-step program will not be an
effective treatment tool for them. Treatment programs for meth
addiction have evolved based on our increased understanding of what
works and what doesn't, but more progress is still needed.
As a social scientist myself, I find all of these to be interesting
and compelling research challenges. Before I close, I'd also like to
mention that a bipartisan law was passed through our Committee in 2007
that addressed methamphetamine, specifically with a focus on the lack
of national standards for remediation of meth labs. For every pound of
meth produced, five to six pounds of toxic by-products remain in walls
and carpets, as well as ventilation and waste water systems. Perhaps
it's worth this Subcommittee, through its jurisdiction over NIST,
reviewing where we stand now with respect to remediation standards. I
think this is an area in which we can work again on a bipartisan basis
for the health of our first responders who investigate meth labs and
citizens in those communities.
Again, I look forward to hearing from the witnesses and hope that
the testimony can get us thinking about how research can help us better
tackle the increasing meth addiction problem plaguing our communities.
Thank you Mr. Chairman. I yield back the balance of my time.
Chairman Bucshon. Thank you, Mr. Lipinski.
I now recognize the Chairman of the full Committee, Mr.
Smith, for his opening statement.
Chairman Smith. Thank you, Mr. Chairman.
Six weeks ago, this Subcommittee held a hearing on the
frontiers of human brain research. During that hearing, our
witnesses discussed many different neurological disorders,
including Alzheimer's disease, autism, epilepsy, Parkinson's
disease, and traumatic brain injury. However, witnesses did not
have the opportunity to discuss another important disorder,
namely addiction, which affects millions of Americans and their
families.
Our witnesses this morning will testify about how meth
addiction leads to severe medical and social consequences, and
why this drug is particularly destructive to the addict. The
meth problem is an example of a clear societal need where
science can yield potential solutions that will benefit the
American public. Progress on this problem, like many other
complex medical issues, will require an interdisciplinary
approach that will inform the scientific basis of meth
addiction and treatment.
The National Science Foundation will play an integral role
in achieving a more complete understanding of this problem.
Hypothesis-based data-driven social science research can be
used to understand the behavioral science behind addiction.
Scientists should work with health officials to develop
predictive models and algorithms that could aid law
enforcement. Applied mathematicians should work with
neuroscientists to develop the mathematical tools necessary to
build a quantitative model that could help explain the
neurological factors behind addiction. These are just a few
examples where NSF money can be effectively spent to help solve
an important societal problem.
I look forward to the witnesses' testimony and the
questions, and I would especially like to thank a constituent
of mine, Dr. Jane Maxwell from the University of Texas, for
being here this morning and for her participation.
Mr. Chairman, finally, I explained to the witnesses a few
minutes ago that, unfortunately, I have another Committee that
is holding a classified briefing that I have to attend, that
began 20 minutes ago so I am going to have to excuse myself. I
do want to reassure the witnesses that I have seen their
testimony and we appreciate, again, their contributions.
Thank you, Mr. Chairman, and I yield back.
[The prepared statement of Mr. Smith follows:]
Prepared Statement of Full Committee Chairman
Lamar S. Smith
Thank you Chairman Bucshon for holding today's hearing.
On July 31st, this Subcommittee held a hearing on the frontiers of
human brain research. During that hearing, our witnesses discussed many
different neurological disorders, including Alzheimer's disease,
autism, epilepsy, Parkinson's disease and traumatic brain injury.
However, witnesses did not have the opportunity to discuss another
important disorder, namely addiction, which affects millions of
Americans and their families.
Our witnesses this morning will testify about how methamphetamine
addiction leads to severe medical and social consequences, and why this
drug is particularly destructive to the addict.
The meth problem is an example of a clear societal need where
science can yield potential solutions that will benefit the American
public. Progress on this problem, like many other complex medical
issues, will require an interdisciplinary approach that will inform the
scientific basis of meth addiction and treatment.
The National Science Foundation (NSF) will play an integral role
towards a more complete understanding of this problem. Hypothesis-based
data-driven social science research can be used to understand
behavioral science behind addiction.
Scientists should work with health officials to develop predictive
models and algorithms that could aid law enforcement. Applied
mathematicians should work with neuroscientists to develop the
mathematical tools necessary to build a quantitative model that could
help explain the neurological factors behind addiction. These are just
a couple of examples where NSF money can be effectively spent towards
an important societal problem.
I look forward to the witnesses' testimony and questions and I
would especially like to thank a constituent of mine, Dr. Jane Maxwell
from the University of Texas, School of Social Work, for her
participation this morning. And I yield back.
Chairman Bucshon. Thank you, Chairman Smith.
If there are Members who wish to submit additional opening
statements, your statements will be added to the record at this
point.
[The prepared statement of Ms. Johnson follows:]
Prepared Statement of Full Committee Ranking Member
Eddie Bernice Johnson
Good morning, I would like to thank Chairman Bucshon for holding
today's hearing to explore solutions to meth addiction using scientific
research.
Methamphetamine and other drug addictions wreak havoc on so many of
our communities. The Office of National Drug Control Policy reports
that North Texas is a national distribution center for the crystal form
of methamphetamine and other illicit drugs because of its
transportation and financial infrastructures and its proximity to
Mexico. But meth addiction knows no bounds. Meth use crosses most
demographics including gender, age, and race, and may include parents,
teens, the unemployed, the homeless, and veterans. With 15 years of
experience as a Chief Psychiatric Nurse at the Dallas VA, I recognize
the challenges faced by soldiers returning home and the unfortunate
battle many of them face with addiction and substance abuse.
Research shows that the brain is substantially changed after heavy
meth abuse. Our witnesses today will be testifying about the chemical
changes that take place in the brain and that describe the chronic,
relapsing disease that is addiction. They will also discuss some of the
behavioral changes associated with addiction and the long-term injury
to the brain. Meth abuse leads to depression, aggressive behavior,
paranoia and hallucinations. Contributing to meth's formidable effects
is the exponentially more potent methamphetamine coming out of Mexico.
These degenerative changes to the brain, and associated behavioral
changes, have some similarities to findings in people with
schizophrenia, bipolar disorder and Parkinson's disease. These
similarities reinforce the need to bring many different kinds of
experts together to solve this problem. We must encourage and support
interdisciplinary work between neurobiologists who study the science of
the brain and behavioral scientists who study the actions and reactions
of humans. But we cannot make a dent in finding solutions to the meth
problem unless these groups of researchers share the findings from
their research with clinicians, prevention and treatment specialists,
and law enforcement. And for the sake of the children, we must make
more than a dent. As I said in July at this Subcommittee's hearing on
the BRAIN Initiative, I am so proud of this kind of interdisciplinary
and translational research being done on brain disorders, including
addiction, at the University of Texas at Dallas' Center for Brain
Health.
We must find better ways to treat addicts, but prevention is our
best hope. In September 2011, the Greater Dallas Council on Alcohol &
Drug Abuse received a $125,000 grant from the White House Office of
National Drug Control Policy's Drug Free Communities Support Program.
The Drug Free Communities program has already proven to be an effective
tool in reducing substance abuse and providing children with the
necessary tools to make more informed decisions about their future. I
look forward to hearing about the latest prevention programs targeted
to school-aged kids and based on scientific studies of adolescent
behavior. A recent study reports that in 2012, 1.6 percent of seventh
graders and 3.4 percent of twelfth graders in Texas had used meth. The
fact we even have drug statistics for 12-year olds is truly
disheartening. We must stop this steady and sad trajectory. We need
more educational programs in place supported by the type of research
done by our witnesses today.
We must all continue to work tirelessly to ensure that we create
effective public policies addressing drug prevention and effective
treatment programs.
Thank you Mr. Chairman. I yield back.
Chairman Buschon. At this time I will introduce our
witnesses. The first witness today is First Sergeant Niki
Crawford from the Indiana State Police. She is also the
Commander of the Methamphetamines Suppression Section. Sergeant
Crawford received her bachelor's degree from Indiana University
in secondary education, and since 1993, she has been with the
Indiana State Police and has served in various capacities in a
variety of locations around the state. Her responsibilities
with the Methamphetamine Suppression Section include overseeing
all operations of the 125-member Indiana State Police
clandestine lab team and supervising 18 full-time personnel
assigned to the Methamphetamines Suppression Section.
Our second witness is Professor Edythe London from UCLA.
Professor London is an internationally recognized expert in the
study of drug addiction. At UCLA she is the Thomas P. and
Katherine K. Pike Chair of Addiction Studies and is a Professor
in the Departments of Psychiatry and Biobehavioral Sciences in
addition to the Department of Molecular and Medical
Pharmacology. She received her doctoral degree in pharmacology
and toxicology from the University of Maryland. Before joining
UCLA faculty in 2001 she worked at the National Institutes of
Health for two decades conducting independent research at the
National Institute on Drug Abuse. In 2008 she received the
Marian Fischman award from the college on problems of drug
dependence.
Our third witness today is Professor Jane Maxwell, who is a
Senior Research Scientist in the Social Work School at the
University of Texas Austin. Her research specialties include
trends and patterns of substance abuse both nationally and
internationally. She is a principal investigator on a grant
from the National Institutes of Drug Abuse to study patterns of
methamphetamine use in the Central Texas area. She has been a
Fulbright Senior Specialist and a member of the National
Institute on Drug Abuse's Epidemiology Work Group for 25 years.
Our fourth and final witness is Professor T. Celeste
Napier, who is the Director of the Center for Compulsive
Behavior and Addiction and a Professor in the Departments of
Pharmacology and Psychiatry at Rush University Medical Center
in Chicago. Dr. Napier has over 30 years of research related to
brain and behavioral effects of abused substances and impulse
control disorders that have been supported by grants from the
National Institutes of Health and other private research
foundations. She is the author of over 200 scientific
publications, special issues, and books.
Thanks again to our witnesses for being here this
afternoon. As our witnesses should know, spoken testimony is
limited to five minutes, after which the Members of the
Committee will each have five minutes to ask questions.
I now recognize First Sergeant Crawford for five minutes to
present her testimony. Welcome.
TESTIMONY OF Sgt. NIKI CRAWFORD,
FIRST SERGEANT,
METH SUPPRESSION SECTION COMMANDER,
INDIANA STATE POLICE
Sgt. Crawford. Chairman Bucshon, Ranking Member Lipinski,
and distinguished Subcommittee Members, thank you for allowing
the Indiana State Police to be here to present to you on our
meth lab epidemic.
As you can see in Table 1 and Appendix A of the written
testimony submitted, Indiana has seen the problem of local
manufacture of meth rise over the past two decades, and the
problem exists in every corner of our state.
We have seen a variety of cook processes over the years,
but the most significant change came around 2006 when we began
to see the one-pot or the shake-and-bake labs where the entire
meth cook is completed in a plastic bottle, glass jar, or other
homemade reaction vessel. Because the one-pot labs are used
with noncompatible chemicals, more injuries to both meth cooks
as well as law enforcement officers are occurring. The
corresponding data can be found in Table 2. One-pot labs are a
much quicker, easier, and smaller way to manufacture meth.
Everyone asks the question why are meth labs so pervasive?
What is the difference between meth and other drugs? From a
law-enforcement perspective the difference that we see is that
the vast majority of the meth labs in Indiana are not money-
driven operations. They are addiction-based labs fueled by the
need for a drug whose chemical precursor pseudoephedrine and
the other chemical reagents used are readily available in local
stores. Drug addicts are in a position where they can
completely control their own destiny in terms of easy access to
the chemicals and the ability to manufacture the drug--their
drug of choice.
On January 16 of 2006 the Indiana State Police launched the
Methamphetamine Suppression Section, which consisted of
personnel assigned full-time to investigate meth crimes. The
State Police personnel historically and currently respond to 97
percent of all labs seized in the state. At about the same time
we launched the Meth Watch program, it focused on deterring
meth cooks by educating retailers and citizens and putting
smurfs on notice that we were watching purchases of certain
chemicals. Smurfs by definition are those people who purchase
pseudoephedrine products and other reagent chemicals to be
diverted to the meth cooks.
Meth Watch kits consist of posters, signage, employee
training materials, and brochures. The program was expanded to
include stickers to warn thieves and tamper tags to track the
thefts from anhydrous ammonia tanks. The success of the program
was in the building of investigative relationships between law
enforcement and retailers and citizens who sell and also use
the products. However, the disappointment of the program was it
did little to deter the smurfs and meth cooks. A sampling of
the Indiana Meth Watch items have been provided to the
Committee for your review.
Following the launch of the Meth Watch, the state police
also launched the Indiana Meth Investigation System, also known
as IMIS. The front end of IMIS is an informational website and
the link is in your packet. The backside of IMIS was a secure
meth investigation database for law enforcement to use.
Although the state police knew IMIS would not be a preventive
measure, it did allow more--excuse me--more efficient
investigations and lab reporting both on the state and Federal
level.
In 2011 Indiana, as well as many other states across the
country, were mandated by law to use the National Precursor Log
Exchange or NPLEX. NPLEX is a national electronic tracking
system of pseudoephedrine products. NPLEX was lobbied for under
the pretext that it would prevent the illegal purchase of
pseudoephedrine products by blocking sales that exceeded the
legal limits, and therefore, it would prevent meth labs.
Unfortunately, this has not been the case. The meth cooks
response has been to double and triple their smurf groups to
accommodate the law changes that have been made.
As stated earlier, the GAO did a study where they studied
the results of tracking states versus controlled substance
states, and in the country, Mississippi and Oregon are two
states that returned pseudoephedrine to a prescription-only
status.
There are a few pseudoephedrine products that are being
marketed as meth-resistant. The technology focuses on the
prevention of the extraction of pseudoephedrine from the tablet
and impeding the conversion of pseudoephedrine to meth directly
from the tablet. It is exciting to see companies working on
this technology and in that direction, but of all the samples
provided to DEA, their chemists have been able unfortunately to
defeat the technology to some extent.
Ladies and gentlemen of the Committee, the word for the day
is smurf. Most meth cooks and smurfs are also involved in other
property crimes such as burglary and theft. However, the newest
and most pervasive crime growth has been smurfing itself. With
the establishment of the NPLEX system and mandated block sales,
the black market for pseudoephedrine products has significantly
expanded. Meth cooks are soliciting the services of family,
friends, coworkers, college students, homeless people, and most
commonly, other meth addicts to purchase their pseudoephedrine
projects.
Bottom line, PSE products have become currency to meth
cooks. The meth cooks pay between $20 and $100 for every box of
pseudoephedrine or they trade a box for a half a gram of meth,
which has a street value of $50.
There is rampant child neglect, endangerment, physical, and
sexual abuse among the children being raised in these meth lab
homes. Table 6 illustrates the growing number of children that
are being identified in homes and locations where we have
seized meth labs. As the parents' addiction grows, the lack of
supervision of their children also grows.
The meth lab crisis is not an easy problem to solve but
this particular drug problem causes much deeper damage to
people and communities than other drug crimes. Those of us in
law enforcement who have chosen this route in our career know
that we will deal with drug-endangered and abused children,
theft, burglary, and violence. Communities are dealing with
contaminated homes that lead to innocent illness of parties,
abandoned properties reducing property values, and fewer
employable citizens to contribute to the economy.
As federal, state, and local leaders determine if
additional steps are necessary to combat this problem, rest
assured that we in law enforcement will remain on the front
lines enforcing the applicable laws and fighting for the safety
of our children and communities.
[The prepared statement of Sgt. Crawford follows:]
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Chairman Bucshon. Thank you very much.
I now recognize Dr. London for her testimony.
TESTIMONY OF DR. EDYTHE LONDON,
THE THOMAS AND KATHERINE PIKE PROFESSOR
OF ADDICTION STUDIES,
DIRECTOR OF THE UCLA LABORATORY OF
MOLECULAR NEUROIMAGING AT THE
DAVID GEFFEN SCHOOL OF MEDICINE,
UNIVERSITY OF CALIFORNIA AT LOS ANGELES
Dr. London. Chairman Bucshon, Ranking Member Lipinski, and
Members of the Subcommittee, thank you for the opportunity to
testify on the problem of methamphetamine addiction. My name is
Edythe London, and I direct the Laboratory of Molecular
Neuroimaging of the David Geffen School of Medicine at UCLA.
I would like to note at the outset that strong support from
Congress to the National Institutes of Health and its grantees
over the past two decades has enabled research that is driving
the development of new treatments for this problem, which needs
your continued support.
Among illicit substances, methamphetamine and amphetamines
in general are second only to marijuana in prevalence of use
worldwide. Methamphetamine abuse is associated with crime,
premature mortality, lost productivity, and a host of medical
problems. Illegal methamphetamine use in our country is now
reduced from the levels in 2006, but the problem is still very
severe where there are established cores of users and supply
connections set up with the Mexican cartels.
In California, for example, admissions to treatment for
methamphetamine use disorders in recent years exceeded those
for all other substances, including alcohol. Like cocaine,
methamphetamine augments the action of dopamine, but it is a
more effective stimulant, has a longer duration of action, and
is more potent, addictive, and toxic than cocaine. It also is
relatively easy to manufacture and has, as you just heard, a
low street cost.
Methamphetamine users stay under the influence for extended
periods with sleep deprivation and poor health maintenance,
leading to medical and psychiatric problems such as prolonged
psychosis and suicide attempts. Methamphetamine use also is
highly associated with HIV infection and in men who have sex
with men.
Brain imaging techniques such as magnetic resonance imaging
and positron emission tomography, MRI and PET, have helped
clarify the effects of methamphetamine use on brain structure,
chemistry, and function.
[Slide]
This slide shows the difference-maps of the lateral surface
of the brain obtained with high-resolution MRI in a group of
methamphetamine users and healthy controls. Red indicates a
gray matter deficit in the methamphetamine group, especially in
the prefrontal cortex on the right lateral surface in a region
important for inhibitory control. Deficits are also seen in
medial aspects of the brain, and volume loss in the hippocampus
is related to memory deficits. Unexpectedly, white matter shows
hypertrophy. The findings suggest a pattern of deterioration
that promotes cognitive impairment. The white matter
hypertrophy may reflect reactive gliosis secondary to neuronal
damage. These abnormalities accompany deficits in the brain's
dopamine system, which functions in reward processing,
motivation, self-control, and decision-making.
PET scans have revealed low levels of dopamine receptors
and dopamine transporters and hypofunction of dopamine neurons.
Notably, markers for dopamine system integrity predict the
outcome of behavioral treatments for methamphetamine use
disorders.
Functional MRI, which measures brain activity during
cognitive processing, has shown that methamphetamine users
recruit less neural activity in the prefrontal cortex than
healthy controls while learning, paying attention, and being
engaged in emotion processing. Functional MRI also can help
evaluate the effects of potential treatments.
These fMRI brain activation maps show the response to
modafinil in cortical regions while methamphetamine users are
performing a task that requires inhibitory control. The
activation corresponds to improvements in learning, and
modafinil is an agent that improves dopaminergic activity and
has cognitive benefits.
At this time, behavioral treatments are the most effective
ones for methamphetamine dependence, but they don't help
everyone. Efforts to identify a broadly effective medication
for methamphetamine dependence have not been successful, but
there are some promising leads such as bupropion, which reduces
use in a subgroup of patients. Studies from animal models and
PET scans of humans have also identified other potential
medications, buspirone and microglial activation inhibitors,
such as ibudilast.
This work has required collaboration of physicists,
mathematicians who developed and improved the instrumentation
and algorithms for data acquisition and analysis, as well as
psychologists and clinicians. The field would be advanced with
the development of new and more sensitive probes, but we need
multidisciplinary teams. Such collaboration, for example, has
proven that deep brain stimulation can be an effective
treatment for depression. This advance required the confluence
of several fields, including bioengineering, electrical
engineering, materials science, neurosurgery, MRI physics,
psychology, and neuroscience. Optimizing therapeutics for
methamphetamine addiction requires this type of
multidisciplinary effort.
[The prepared statement of Dr. London follows:]
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Slides
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Chairman Bucshon. Thank you very much.
Dr. Maxwell.
TESTIMONY OF DR. JANE MAXWELL,
SENIOR RESEARCH SCIENTIST,
SCHOOL OF SOCIAL WORK,
UNIVERSITY OF TEXAS AT AUSTIN
Dr. Maxwell. Thank you. My thanks to you and to the Vice
Chair for inviting me and I hope maybe I can shed some light on
looking at this problem from an epidemiological standpoint or
historically.
We know that until 1970 we really didn't have a
methamphetamine problem because amphetamine was available over
the counter. Amphetamine was scheduled in 1970 and that is when
we first began to see problems with methamphetamine. They were
using the P2P or the phenyl propanone, a precursor that we are
now seeing used in Mexico. And for the first ten years it was
the bikers, and remember the ``crankcase'' meth where they were
carrying it in crankcases producing the meth.
In 1980 phenyl propanone was forbidden in the United States
and that is when they started using pseudoephedrine.
[Exhibit 1]
And this slide is very busy but there is an easy message in
it. If you look at the red lines, vertical lines, that is every
time either the United States or Canada had passed a precursor.
And you can see that we--the first precursor, the purity of
methamphetamine drops, then it goes back up again; another
precursor ban, it drops, it goes back up again. So this is a
drug that is very cyclical. We do one thing to it and think
maybe we are making progress and then it rebounds.
[Exhibit 2]
This slide shows what the market looked like right after
the law was passed limiting the ability to buy pseudoephedrine.
The far left is the price and purity right after the law goes
into effect. Then you see the price going--skyrocketing and
then dropping off. You see the purity, the blue line dropping
and then going up. And the intersection of interest is the one
with the second green area. This is the middle of 2008. This is
when the Mexicans first really started distributing the P2P
meth in the United States. And since then the prices dropped
dramatically. And we are now up to about 94 percent purity of
the meth that is being tested by DEA.
[Exhibit 3]
Two other data sets that are of use, the blue line is
showing the proportion of all the methamphetamine that is
tested that is now made from the P2P process. So it is about 93
percent; about another two to three percent is made from the
pseudoephedrine. Now, one of the things that is not shown in
this is a DEA-only test where the seizure is more than six
grams, so a lot of the small amounts of meth that are made in
the shake-and-bakes would not be tested.
Basically, the market really in terms of the massive
quantities is now the P2P. The red is the drop-off in the last
two years in the number of precursor clandestine labs as
reported to DEA. I am not sure what is going on but we may be
seeing the Mexican meth beginning to move in other areas and
perhaps overtaking some of these small labs.
[Exhibit 4]
This is the Texas data and I put it up there because it is
15 years of data, and the red line is 2006 so you can see after
we get the precursor, whether it is the deaths or poison center
exposures or treatment admissions or tox lab incidents, they
all drop after 2006 in Texas. They are now going upwards again.
So another cycle.
And besides using the quantitative data, I always get out
on the street and ask people who are working out on the street
what is going on. They are telling me now they are seeing more
psychosis now than they saw six months ago among the users. The
meth is very, very pure. The high is very, very intense, more
use of needles, syphilis is up. DEA is reporting more and more
seizures in the Dallas area of 100 pounds or more, and the
reporting availability of meth is higher than it has ever been.
So more bad news.
[Exhibit 5]
This is a map of the tox lab data from DEA, and basically
it is showing, yes, meth is a problem in the West. But there
was something else that really bothered me and I went and
looked at the data. This is 2010 and there are seven states in
the Northeast that are white. They don't show--so they had--
they reported no meth in 2010. When I ran the data last night,
we are down to only three states that didn't report meth in
2013.
[Exhibit 6]
And this is a report. I am a member of NIDA's Community
Epidemiology Work Group, the members reporting no diminution in
meth. It is not decreasing. It is increasing or staying stable.
You asked for information on data and methodologies and I
put this in here for the--your assistance to use. So with that,
I thank you.
[Exhibit 7]
[The prepared statement of Dr. Maxwell follows:]
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Chairman Bucshon. Thank you very much.
Dr. Napier.
TESTIMONY OF DR. CELESTE NAPIER, DIRECTOR,
CENTER FOR COMPULSIVE BEHAVIOR AND ADDICTION,
PROFESSOR OF PHARMACOLOGY AND PSYCHIATRY,
RUSH UNIVERSITY MEDICAL CENTER,
CHICAGO, ILLINOIS
Dr. Napier. Chairman Bucshon, Ranking Member Lipinski, and
distinguished Members of the Subcommittee, thank you so much
for the opportunity to testify on how science can provide
solutions to the problems associated with methamphetamine
abuse.
Methamphetamine is an insidious drug, and while the user
initially experiences an incredible sense of euphoria, the
brain's natural brake system is overridden, and the
consequences of this overload can be devastating.
Methamphetamine can cause brain abnormalities that occur even
years after the addicted individual stops using the drug, and
understanding these persistent abnormalities is an important
topic for modern neuroscience.
Pilots of my own research can underscore this point. We
studied the effects of methamphetamine in laboratory rats.
These rats readily learned to press a lever in order to receive
an infusion of methamphetamine into their bloodstream, and if
we let rats self-administer methamphetamine for two weeks and
then leave them alone for different periods of time, we find
that by three weeks of abstinence, the rats' brains had
degenerated and they looked similar to the brain of a human
that has Parkinson's disease.
Such findings provide neurobiological explanations to
recent reports that human methamphetamine addicts have a 75
percent greater risk to develop Parkinson's disease than do
controls. An increasing prevalence for Parkinson's disease has
enormous health and medical cost ramifications, and we are now
working to identify viable biomarkers of Parkinson's-disease-
like pathology in methamphetamine abusers with the hope that
presymptomatic detection will allow early therapeutic
interventions to avoid this outcome.
As suggested by these studies, effective treatments for
methamphetamine abuse may be those that work after the drug-
taking has stopped. Indeed, relapse by the withdrawn addict is
as high as 70 percent and thus halting relapse is a high
priority for medication development.
Basic research has identified treatments that reduce
relapse-like behavior in laboratory rats, as Dr. London had
indicated. We are using treatment protocols that are already
used in humans to treat other diseases. Such a repurposing
provides a rapid--a relatively rapid and cost-effective process
to bring treatment to market.
To attract the interest of pharmaceutical industry to the
patent opportunities of this endeavor, we are working with an
innovative foundation named Cures within Reach. This foundation
is stewarding fundraising for repurpose treatments that we
think should reduce cocaine and methamphetamine use. We feel
that teaching old drugs new tricks is a win-win model that
should be explored to its greatest extent by academic
biomedical researchers, government agencies, foundations, and
pharmaceutical companies alike.
An example of the urgent need to develop effective
treatments for addiction is in our Nation's jails and prisons
where approximately 80 percent of the incarcerated have
substance abuse problems. As drug courts mandate treatment, we
are working with the continuing legal education programs to
integrate the neuroscience of addiction in order to help inform
sentencing decisions. I think that such knowledge base is
especially important for methamphetamine cases for which
coerced treatment is often the only way that the addict will
access help.
Particularly vulnerable to the ravages of methamphetamine
are the Nation's youth, as Mr. Lipinski mentioned. Each day in
the United States more than 4,500 children try an illicit drug
for the first time. As these striking data suggest, the
traditional approach to drug education is largely ineffective.
New strategies are critically needed and I believe there is a
role for neuroscience in this endeavor.
Recent initiatives by the Robert Crown Center for Health
Education, a not-for-profit organization based in a suburb of
Chicago, in conjunction with our addiction center at Rush
University, is providing what I believe to be an excellent
template for this goal. The Robert Crown Center is developing a
completely new educational framework that integrates knowledge
and building strategies for middle school, high school
students, school personnel, and parents. Our center provides
access to cutting-edge brain research. Thus, the prevention
program includes both the neuroscience-based knowledge of how
abused drugs act on the adolescent brain, as well as the
socioeconomic learning required to reduce drug abuse among our
youth.
Understanding how the brain goes awry during
methamphetamine abuse is a formidable challenge. The exciting
advances that we made towards this challenge attest to the
ingenuity and determination of the addiction neuroscientist.
But to continue this trajectory we must carefully consider
where to direct our resources. Successful templates should be
supported and promising new paradigms should be considered.
Education programs need to be promoted to translate the wealth
of empirically derived neuroscience to our public.
However, with concerted teamwork from all sectors of our
society, I am confident that we can meet the challenge of
controlling the abuse of methamphetamine and reducing the
suffering of those who struggle with addiction. Thank you.
[The prepared statement of Dr. Napier follows:]
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Chairman Bucshon. Thank you all for your testimony.
I remind the Members of the Committee rules limit
questioning to five minutes, and the Chair at this point will
open the round of questions. I recognize myself for five
minutes.
Dr. Maxwell, from an epidemiological viewpoint--urban
versus rural communities, is there a difference in
methamphetamine--because I am in a relatively rural area of
Indiana--versus Chicago, for example?
Dr. Maxwell. The difference is that treatment resources
aren't available in the rural areas. I don't see any difference
in the patterns of urban versus rural but serious need for
treatment facilities in the rural areas.
Chairman Bucshon. Sergeant Crawford, in Indiana, do you
notice a difference?
Sgt. Crawford. We saw a big difference back in the late
1990s and early 2000s when meth labs really started to grow.
The vast majority of them were in rural areas. But now, with
the one-pot or the shake-and-bake labs coming in, we are
getting more and more labs in urban areas. I think within
Indiana, Allen County and even Vanderburgh County, while it has
got some rural areas, it is second- or third-largest city, so
if you look at those two counties and the growth that they have
seen, that kind of shows you that with the one-pot labs, it is
much easier to cook in an urban area.
Chairman Bucshon. You were commenting on how it wasn't
necessarily economically driven; it was addiction-driven. Dr.
Napier, maybe you can comment on this? I have heard that in
certain respects, you know, as methamphetamine tries to
overtake cocaine, for example, or other drugs that are being
sold by certain groups of individuals in urban areas, that in
areas where there is a strong dealer in cocaine, and that is
where the money is, that methamphetamine has a hard time
breaking into that area. Is that true or not true? Is that
perception? Dr. Maxwell and then Dr. Napier?
Dr. Maxwell. No, cocaine is down. There is a shortage of
cocaine because a lot of it is going to Europe now. And I am
hearing more and more people who are shifting to
methamphetamine because cocaine--what we are--the cocaine that
we are getting is not very pure. It is not worth ``paying
for.'' No, they are going to methamphetamine now. Meth has far
out-passed in most of the states cocaine in terms of
prevalence.
Chairman Bucshon. Dr. Napier, in Chicago?
Dr. Napier. By understanding what is happening in Chicago
is two things. One is it is still a very rural problem.
Southern Illinois, as Mr. Lipinski knows, has some clandestine
labs that are really supplying the problem there. In Chicago
there are certain subpopulations of people that abuse
methamphetamine more than others. For example, men who have sex
with men or the gay men community are one of the higher users
of methamphetamine in the City of Chicago. In the south side of
Chicago and the west side of Chicago, cocaine is still the
preferred drug. But we are--I predict that we will be seeing
more methamphetamine infiltrating the city as it becomes more
readily available.
Chairman Bucshon. Dr. London, in the area of research--and
I know you do research on the effects of it, I have discussed
with FDA about trying to find ways to make pseudoephedrine not
usable to produce meth. Are you aware of universities and other
people--other in industry that are doing that type of work?
Dr. London. I am not aware of that.
Chairman Bucshon. Yes, and I think, Sergeant Crawford, you
mentioned some of that, that tamper resistance and things like
that, it is a very interesting subject because pseudoephedrine
in and of itself isn't going to be a Schedule I drug because it
is just not a Schedule I drug. So attacking it from the FDA
standpoint and trying to schedule one drug based on the fact
that it is used to produce another drug is not something that
can be done at this point because of legal and other
challenges.
So I am interested in the science of trying--of not only
finding ways to treat people that are on it but trying to make
it more preventable to make it in rural areas like in Indiana.
I recognize the fact that a lot of this is going to come from
Mexico and that is a different problem to attack. So we really
have two separate problems here, I think as it relates to that.
And with that, I will yield to Mr. Lipinski.
Mr. Lipinski. Thank you. I want to thank all the witnesses
for their testimony. This is fascinating to hear this and very
troubling in many ways.
I want to start out with Sergeant Crawford. As I mentioned
in my opening statement, the Methamphetamine Remediation
Research Act passed through this committee in 2007. I was a
cosponsor. I believe it was spearheaded by the then-Chairman of
the committee Bart Gordon from Tennessee. In that bill, which
became law, it established a research program on residue from
methamphetamine production and developed voluntary guidelines
for preliminary site assessment and remediation of meth labs.
You know, at that time most meth was--that was cooked was
cooked in drug houses. As you spoke about and others, you know,
the new shake-and-bake method of cooking, seizures aren't
restricted to collecting items in drug houses.
So if this committee were to revisit the law that I
mentioned, we would need to take this into consideration. Is
there anything you could say about the new kinds of immediate
or long-term risks, if any, that are faced by law enforcement
officials and surrounding communities giving the--given the
prevalence of the new method?
Sgt. Crawford. I think the biggest issue that we are having
is really in terms of the dangers associated with the one-pot
labs. When we first started to see them, we didn't really
understand. We knew--we understood the chemistry but we didn't
understand the long-term effects, and we didn't realize what an
enormous amount of ammonia gas that the one-pot labs actually
create. And so when you look at injuries, especially to law
enforcement, that is our issue that we are dealing with right
now is the exposure to the ammonia gas that comes off of the
one-pots because it creates its own ammonia gas within the
reaction vessel itself.
So in terms of the contamination that we are dealing with
with these labs, whether it is a one-pot lab or other, is
typically going to be your ammonia gas. But the bigger issue is
in the last step of the process when they salt out or they
solidify the meth and they introduce hydrochloric acid gas to
the reaction vessel, those molecules bond with one another, and
because it is a gas, it escapes into the air. And that is
typically the types of exposures that we are dealing with, both
long-term exposures from facilities or homes or cars or
whatever it is that have had cooks happen in them, especially
long-term. Automobiles are a little bit less because you can
roll the windows down. They are smaller. They are not going to
hold in the contamination as much as others, such as a house or
a hotel room would.
Mr. Lipinski. Thank you.
Dr. Napier, I wanted to ask you, you had talked about these
new programs for--educational programs. Is there anything more
that you would like to see us doing here in Washington that
would help to--help the research that would feed into these
programs or in the helping to disseminate the findings of
research and get those--get this out to people?
Dr. Napier. There is always room to grow and help needed.
From my perspective in working with these outstanding
educators, one of the things that we really are trying to do is
to determine if--outcomes. Are we really making a difference
with our new curriculum? So we have several schools that have
served as beta test sites in the Chicago metropolitan area, and
we are just now getting feedback from our first year of
implementing this curriculum in different schools.
What we need to be able to do is to customize this
curriculum to the individual community schools and then
determine if we are as effective in the different environments,
because clearly, the way we are going to reach children, for
example, in rural areas is going to be quite different than
what we are going to be needing to use in the suburban parts of
Chicago.
So this kind of epidemiology and this kind of validation of
outcome-support takes money. We have to hire people to do this;
we have to have researchers employed. And so this again is an
area where grant support mechanisms could be very critical in
driving the momentum to get this thing to the schools as quick
as we can.
Mr. Lipinski. And is the--what about the funding for the
research that is going on to learn more and to improve these
educational programs? Is there--I know there is always a need
for--you could say for more but is there anything that is
missing, anything that can be done differently?
Dr. Napier. Well, there are mechanisms for this kind of
educational directives if you will through both the NIH and at
NIDA, as well as NSF. And I think that what we need to do is to
take those vehicles and optimize them. One idea that we might
explore actually, as you know, all of these programs have
training grants, so we are putting young people in their Ph.D.
programs on training grants that are being supported by NIH.
One of the things we might consider to do is that there
would be a component required of these training grants to have
these students volunteer, and this could be part and parcel to
their training and part and parcel to the institutions getting
the grant awarded. And I think that kind of infusion of these
are young men and women who are going into the neurosciences
who are right out of college, and having them work in these
different high schools and junior highs would be a huge
infusion of great knowledge and understanding that would be
very useful in these kinds of programs. So that is something
that might not cost so much money that might be very effectual.
Mr. Lipinski. All right. Thank you.
Chairman Bucshon. I now recognize Mr. Schweikert for his
questioning.
Mr. Schweikert. Thank you, Mr. Chairman.
Professor London--and forgive me, some of my knowledge on
this is a bit outdated, but walk me through methamphetamine and
its attachment to the receptors. Is it different than other
opiates in both the dopamine receptors and other parts in the
brain?
Dr. London. Methamphetamine interacts with the dopamine
transporter.
Mr. Schweikert. Um-hum.
Dr. London. It is taken up into neurons that use dopamine
as a neurotransmitter. It gets into the vesicle where dopamine
is stored, and reverses the activity of the transporter so that
lots of dopamine is released into the synapse, and these very
high concentrations that are released--much, much more than a
release from the administration of cocaine--are toxic because
dopamine itself in a high concentration will autooxidize.
Mr. Schweikert. Almost to that, wasn't there--and wasn't it
even happening at a couple of the big southern California
universities a couple years ago looking at abilities to almost
block those receptors from absorption? Do you have any memory
of what happened or where that research is?
Dr. London. Yes. At this point with respect to interacting
with the dopamine transporter, one of the best clues that we
have for therapy is with bupropion, which has----
Mr. Schweikert. Okay.
Dr. London. --as part of its action, the ability to enhance
dopamine function by blocking the transporter. It is in a sense
a type of agonist or mimic for the drugs of abuse but without
the abuse potential.
Mr. Schweikert. Okay. So if I remember my little friend who
is trying to explain this to me--she actually sort of drew with
crayons so I would understand it; it is always amazing how, you
know, two times in life you think you know everything: when you
are 14 and when you become a Member of Congress--is it an
actual block on the receptor or is it changing the--as you call
it, the transporter?
Dr. London. Methamphetamine interacts with the presynaptic
element of the neurons. All of the transmission takes place at
the gap in between neurons----
Mr. Schweikert. Um-hum.
Dr. London. --which is called the synapse.
Mr. Schweikert. Yes.
Dr. London. And methamphetamine acts at the first neuron in
the sequence causing massive releases of dopamine. This massive
release of dopamine really destroys the system over time in
that the dopamine receptors that are needed for dopamine to
have its normal activity are down-regulated, and in fact the
presynaptic element doesn't function very well in terms of
releasing dopamine in response to natural rewards.
Mr. Schweikert. Okay. The impossible-to-answer question--
where do you think we are in the research of being able to have
a pharmaceutical sort of solution to at least either blocking
those receptors and would it only be meth specific or would it
be other types of opiates?
Dr. London. Well, meth is not an opiate. It is an
amphetamine, and so it has a different chemical structure. And
the opiates interact directly with other kinds of receptors.
With respect to a treatment that will help all
methamphetamine abusers globally I think we are not in good
shape. But we do have treatments that help subgroups of
methamphetamine users. For example, bupropion is effective in
reducing stimulant use by individuals who use methamphetamine
on fewer than 18 days a month, but not in the heavy users.
There is also a positive signal with bupropion being effective
in men who have sex with men.
There are clues from the recent PET literature and animal
studies that there are other targets that haven't been used as
therapeutic targets that might be useful.
Mr. Schweikert. Okay.
Dr. London. One of them is the D3 receptor, which seems to
be up-regulated in meth users, and blocking it in animals
reduces methamphetamine self-administration.
Mr. Schweikert. All right. Thank you. And I know we are
very short on time.
Dr. Maxwell, wonderful data you have put together. My quick
question is let's say we had great success in strangling the
supply of methamphetamine. When you have been looking at data
particularly in the Texas environment, are there any other
drugs that you see potentially in the upswing either because of
their price or their potency?
Dr. Maxwell. Okay. Two different things: DEA is telling me
that the cause of the pseudoephedrine is not--we can't get
enough of it to collect and the problems with the P2P if Mexico
bans it. We know people are out all over the world in Africa
and South America looking for other chemicals that can be used
to make meth. And in terms of other drugs going up,
methamphetamine continues to go up. I am worried about heroin
among young users and the synthetic drugs, we are just
beginning to understand what is going on with them. And a lot
of them are actually related to methamphetamine. We like
uppers. We like trippy uppers that you can--it is kind of like
combining LSD and, you know----
Mr. Schweikert. See, I have always assumed----
Dr. Maxwell. Yes.
Mr. Schweikert. --that is why the dear Lord created coffee
for me.
Dr. Maxwell. Exactly.
Mr. Schweikert. Mr. Chairman, I yield back. Thank you for
your patience.
Chairman Bucshon. You are welcome.
Dr. Bera.
Mr. Bera. Thank you, Mr. Chairman and Ranking Member
Lipinski, and thank the witnesses.
I am a physician by training and I represent Sacramento
County in the northern California area where we have got a huge
methamphetamine challenge. The Sacramento Bee reported that 40
percent of the men arrested in Sacramento County have meth in
their system. And just as we think we are making some progress,
as Dr. Maxwell showed, those that are supplying are staying one
step ahead of us here.
Increasingly, more of the meth that does seem to be coming
from Mexico does seem to be being smuggled in as liquid as
well. And then I think Sergeant Crawford has talked about the
ease of the shake-and-bake production. So if we focus on the
back end, it looks like it is going to be a very difficult
challenge for us to get a handle on.
On top of that, when I look at our law enforcement at one
time most of our law enforcement agents had narcotics units.
Now, a lot of our police departments have lost narcotic units.
In Sacramento, the Sacramento PD shuttered their narcotics unit
in 2011. So that also adds to the challenge here.
You know, we have seen the ability to provide treatment go
down. In California in 2006 we had 78,000 patients admitted to
meth addiction programs. Less than five years later, it is less
than 44,000.
So I am not painting a rosy scenario here. This is a
challenge. And then concomitant to that, you know, I was chief
medical officer for Sacramento County. The number of folks that
have dual diagnosis--mental illness and substance abuse--the
number of folks that, you know, by not addressing the root-
cause issues, we end up building more jails. We end up having
to build these backend solutions.
The challenge that drug addiction--not just methamphetamine
but cocaine--we are now seeing a huge uptick in prescription
drug abuse and the impact that has on the family social
structure, the impact it has on the foster care system, et
cetera. So there are these huge sociological challenges. I
haven't asked a question yet because these are real issues.
We have talked a lot about backend solutions, but if we
were to look at the root-cause issues and try to shift towards
prevention in some of the social science that it potentially
leads to drug abuse and addiction, I guess I would ask Dr.
Maxwell where would you like us to focus if we were to try to
focus on frontend solutions and root-cause solutions?
Dr. Maxwell. Thank you. We have tried a number of different
approaches on--to prevent youngsters from using drugs. There
have been some that have been proved to be quite effective, but
it seems like we start doing something and then we drop it.
Mr. Bera. Right.
Dr. Maxwell. I really wish we would go back to some of
those prevention programs that have, through the follow-up
tests, been shown to be effective.
Mr. Bera. Because it is probably making a commitment over a
generation, right? I mean if----
Dr. Maxwell. Exactly.
Mr. Bera. So----
Dr. Maxwell. Um-hum.
Mr. Bera. --what would you say some of those programs are
that you would like to see?
Dr. Maxwell. They are up on the SAMHSA website and I can
give your staff the links to it, but some very, very good ones.
So before we start over again, I think it is time to go back
and look at which of those are the most effective and could we
modify them to handle these new drugs?
Mr. Bera. Dr. Napier?
Dr. Napier. And to continue that dialogue, there is a
couple things. One is we have to understand that the
curriculums are regulated by criteria that have to be met, and
so first to come in with a new curriculum adds a huge burden on
our already-burdened teaching system, so we have to be very
sensitive to that.
So what I think is a good approach is a more integrated
approach and it needs to be over the course of the students'
experience in junior high and high school. It can't be you have
a speaker come in and you give a talk in the auditorium and
leave. It needs to be integrated into health sciences, P.E.,
social sciences, and be science-driven. And I think that is
where we have a lot more that we can do to make this better to
where good decision-making is part and parcel to drug
prevention.
And we all know that the adolescent brain is a different
brain than the adult brain, and the capacity to make decisions
is not the same. And we all know that the frontal cortex is not
developed in children until they are 21 or 23. And so we need
to have empirically based curriculum that will reach the
adolescent in terms of these decision-making processes based on
their neurobiology.
Mr. Bera. What would you say the right age for intervention
is if we were to--elementary school?
Dr. Napier. Elementary school.
Mr. Bera. Yes. Okay.
Dr. Napier. Absolutely. And also I think it is important to
think about in urban situations where students drop out of
school, you want to reach those children before the dropout
rate start to escalate. So again, that means starting them
sooner.
Mr. Bera. I am out of time but I don't know if Sergeant
Crawford or Dr. London----
Chairman Bucshon. We are going to do another round of
questioning if you have more questions if you can stay.
Mr. Bera. Okay. Fabulous, thank you.
Chairman Bucshon. Yes. And so we are going to do a second
round for those who can stay.
For whatever it is worth, I have four kids aged 20 to age
9, and Dr. Napier, maybe you can comment on this, but even
though us as parents think we are the ones that have the most
influence over the direction that our children take, in actual
fact, their peer group has probably more overall effect on what
they do every day than we do. And so I found it interesting
when you are talking about having volunteer children or high
school kids who, rather than having the county sheriff come out
and talk about the Just Say No program and things like that,
which also needs to be done, is working on designing programs
that actually get people of the same age that are willing to
interact at a peer-group level, to try to affect that. Do you
think this something that would be effective?
Dr. Napier. Well, I think there are a couple points here
that you made that are really important to bring home. Number
one is the influence of peers. Now, we all know even in basic
research, which is what I do, that people, places, and things
influence the way an animal--in my case, the rat--will make
decisions about taking drugs and the cues associated or the
things that are associated with the drug-taking has a huge
influence on subsequent drug-taking. Now, you superimpose that
on the brain of an adolescent, which is wired to be more
sensitive to these environments and to their friends. That is
the way their brain is made, and then they have hormones.
So all of these factors sort of escalate into this thing we
call a teenager that greatly influences how they are making
choices and who is going to inform them about the kind of
choices they make. So that is why I do agree that getting
younger people that may relate to the students in a more--level
that they can sort of gear into is something that we could
exploit more.
But I don't want it necessarily to be teenagers. My
suggestion had to do--these would be graduate students and
medical students, so they are in their mid-20s that would be
able to come back to junior high and high schools, and they
would have a science-based knowledge that then could be
incorporated into whatever curriculum is being implemented by
that particular school.
Chairman Bucshon. I think that is just a fascinating
subject because, like I said, have four kids, and like
cigarette smoking, for example, there are studies on why almost
every teenager at some point tries cigarettes but only a
certain percentage of them actually become chronic smokers. And
the reason they originally try it is because of peer pressure
and peer group influence. Even in contrast to the factual data
that shows that cigarette smoking in the long run is bad for
your health, most people are not influenced by that when they
try it. But why some people will become chronic cigarette
smokers and others don't is fascinating.
And that in meth, my understanding is you don't have a
second chance a lot of times. I mean once people start to get
on meth with the changes Dr. London has described, you may have
a higher percentage of chronic users of methamphetamine versus
cigarettes, for example, and that is why peer group stuff, I
think, may be important.
Dr. London, once these changes happen, are these permanent?
I mean are these reversible?
Dr. London. There have been studies with positron emission
tomography on both the metabolic pattern in the brain, glucose
metabolism, and also some of the dopamine receptor markers and
structural markers. And in fact what we found is that decrease
in the volume of the striatum, which is a part of the brain
that is very important in reward and motor function, does
recover to some extent. And there can be recovery in as early
as a month of abstinence.
With respect to some of the chemical markers, it takes a
very, very long time to reach recovery and it--at two and a
half years after cessation of chronic methamphetamine use, one
area of the brain that is affected, the thalamus, shows
complete recovery where another area of the brain, the
striatum, does not show complete recovery.
So it is a very long drawn-out process, and it can be very
frustrating for the addict who is approaching a treatment
episode because what happens is that these people, as a result
of the structural and biochemical changes that are very long-
term, are very frustrated when they are in treatment because
the treatments are behavioral treatments, where they have to
exercise some kind of self-control in thought-stopping, and
they are really not very able.
So I think educating the client in addition to ultimately
developing some medications that can help the cognitive therapy
along would be useful.
Chairman Bucshon. Yes, it seems to me from what you just
said is that there will have be medication in addition to other
therapy if we are going to fix this for people who are
chronically addicted to methamphetamine. And so that is why
ongoing research is so critical to try to solve this problem.
We will go to Mrs. Lummis for her questions.
Mrs. Lummis. Thank you, Mr. Chairman.
I sure appreciate the panel's attendance today, your
knowledge, your information.
As you have testified, there was a wave of addiction going
from the West Coast to the East Coast. It swept across my state
of Wyoming into the Midwest leaving almost a lost generation
where children of addicts are being raised by their
grandparents. People in their 30s and early 40s are struggling
with addiction. It was staggering and has affected every
family, including my own. So the work you are doing is just
critical to helping the recovery of this literal generation
that was lost to this addiction that are now adults, young
adults.
Dr. London, I believe it was you that mentioned that the
striatum does not recover after two and a half years whereas
the thalamus does. Can you tell me what the striatum does?
Dr. London. Yes, the striatum has multiple functions. On
the most superficial level we think about the striatum as being
important in motor control. The striatum is the area--one of
the areas that receives a very, very rich enervation of
dopamine neurons from the mid-brain, and it is those neurons
that degenerate in the pathology of Parkinson's disease.
Mrs. Lummis. Oh.
Dr. London. The striatum has other functions as well, and
dopamine signaling in the striatum is very important for
decision-making. We have recently published a report showing
that there is a very, very strong relationship between dopamine
receptors in the striatum and the function of the prefrontal
cortex when a person is deciding to take risk or not take risk.
And so what you see with the damage to the dopamine system in
the striatum is a situation in which the addict really has a
difficult time making the right decision to go to sobriety. It
is as if the drug--the effects of drug-taking reinforce the
addiction.
Mrs. Lummis. So given that physiological understanding, is
there some research that is being undertaken that can affect
the dopamine receptors' ability to recover?
Dr. London. We have some very exciting findings that are
preliminary--strong but preliminary. What we have known is that
even though the dopamine receptors show down-regulation in
methamphetamine dependence, treatments that are aimed directly
at the dopamine receptors, agonist drugs that would make the
receptors work, don't really work very well for methamphetamine
dependence.
Mrs. Lummis. Okay.
Dr. London. Maybe that is because the receptors are down-
regulated so much or the ones that remain are not functional.
And what you really need are fresh dopamine receptors. Using a
different approach, we have an ongoing study where exercise,
moderate exercise in a very controlled study, has shown a very
remarkable up-regulation of the dopamine receptors in--over the
course of eight weeks. And this is very exciting and this might
make that system more amenable to all kinds of therapy, be it
cognitive, behavioral, or pharmacological.
Mrs. Lummis. Thank you, Dr. London.
Would anybody else in the last half-minute I have care to
weigh in on the dialogue that I have been having with Dr.
London?
Well, I am deeply grateful for your testimony here today,
your work on this subject. It is enormously important to my
state of Wyoming and to that wave of young people now in their
30s and 40s that were tremendously affected.
And I would just add that on the Indian reservations in
Wyoming and elsewhere, the Mexican drug cartels chose to set up
base camps, and between the grinding poverty on reservations
and what may be some genetic component to the addiction, they
have been tremendously devastating to our Native American
population as well. So the work you are doing is just
tremendously critical and I thank you very much.
And Mr. Chairman, I thank you and yield back.
Chairman Bucshon. Since I missed that you came in during
the first round, we have done a second round of questioning, so
if you have other questions, I think it would be appropriate to
allow you another five minutes for a second line if you have
any other questions.
Mrs. Lummis. Well, Mr. Chairman, I would just use my time
to ask the members of the panel, is there information that you
would like to share with us that you haven't been able to
convey yet in your testimony? I want to give you a very open
opportunity to make some points that previously have not been
made that you don't want to leave this room without making.
Dr. Napier. I can weigh in first here. I think this is an
incredibly complex scenario and we are not going to find a
resolution probably in my lifetime. But I do think what is
really, really important is to consider this both on the supply
and the demand side and both in terms of prevention and then
adequate treatment, but to understand that treatment may have
to do--have--will have to be highly individualized, because
depending on if we catch someone early in their use and
exploration of methamphetamine versus someone who has used it
for a protracted period of time, that is a different brain
state. That is a different individual.
If we catch them during early withdrawal periods versus
someone like Dr. London was talking about two and a half years
out when they are even motivated to quit using the drug and
they are fighting against their own brain biology that is
influencing their decision-making processes, it is tapping into
the brain that actually--those brain regions that make
decisions that succumb to methamphetamine. So it is a double
whammy. And I think we have to have an appreciation for that.
And I think that is why this multidisciplinary, highly
integrative approach that is going to start young--and
understand that we have got baby boomers now that are moving
into retirement and they are going to be having drug abuse
issues that we are going to have to deal with as a society as
well.
So I do believe it is going to take a multidisciplinary
across institutes, across states and an education end and a
treatment end for us to really make a dent in this problem.
Mrs. Lummis. Dr. London?
Dr. London. We haven't said much about the need for an
integrated approach in pushing the technology with respect to
this problem. And I think we are--especially with respect to
the interest of this particular Subcommittee, science,
technology, and mathematics can really be put into the arena to
move the field forward.
Particularly, we could talk about the combination of
nanotechnology with cutting-edge neuroscience methods. That
combination could be very powerful with nanotechnology giving
you dynamic chemical measurements in very, very discrete areas
of the brain. Already there is cutting-edge
electrophysiological recording that is being combined in
animals with electrochemical detection of glutamate, dopamine,
and other neurotransmitters that can give us a moment-to-moment
readout of how neurotransmitter signaling can modulate
coordinated neural activity.
And so I think that we need to keep in mind that we really
need better tools, and some of these tools could be within our
imaging area. We need to have better radio tracers that will
selectively allow us to evaluate chemical changes in the brain.
Mrs. Lummis. May I interrupt you there?
Dr. London. Of course.
Mrs. Lummis. Where is this research being done now and with
regard to, for example, nanotechnology, radio transmitters? Is
it being done? Where? And is Congress helping fund that?
Dr. London. There is a California Nanotechnology Institute
that is located at UCLA, and I believe it really was an
initiative that has been helped by Congress, although I am not
sure of the specifics there.
What we also really need are education programs for the
specialist. For example, there is a dearth of radiochemists in
the world, and it is a specialty that is really required to
give us those molecules that would allow us to do these
noninvasive measurements.
Mrs. Lummis. Where are they trained? Who trains
radiochemists?
Dr. London. There is a program at Johns Hopkins, there is a
program at the University of Michigan, the Karolinska
Institute, the National Institutes of Health Intramural
programs.
Mrs. Lummis. Thank you. And I want to thank all of you for
your testimony.
Chairman Bucshon. I am going to allow the other two that
didn't get a chance to give their final comments some time to
follow up with what Mrs. Lummis asked to just comment on what
you might want to say to the Committee that you didn't get a
chance in your testimony starting with Sergeant Crawford.
Sgt. Crawford. At first when I saw the list of folks that
were going to be here to testify, it was kind of one of those
situations where I am really glad I slept at a Holiday Inn
Express last night because doctor, doctor, doctor, sergeant.
But I will say one of the things that law enforcement, not
only within our state but across the country, we're very
cognizant that prevention programs are important. And having
come from a background within the State Police where I worked
in our problem-oriented policing section, which focused on
community problems and what do we do to help solve those
problems from our aspect, I think it is important that we
have--you have heard interdisciplinary all morning this
morning, and I think that is such an important thing that it is
so important to get the medical community, the treatment
community, the prevention community, and law enforcement
together so that we can come in from an interdisciplinary.
Because I am pretty good at coming into your junior high
class, the drug and alcohol or the health class and I can give
them a good one-day program, but if we don't have something
leading up to that and we don't have something after that to
focus their attention, then I think it is not a waste of an
hour but it is not as productive as it could be.
And so from our perspective, while we are big into the
enforcement side obviously and do our job to enforce the laws
that are on the books, we do also focus on--within our section
our mission statement is about education, prevention, and
enforcement. And we keep them in that order because we know
with education and--I am sorry, education, partnerships, and
enforcement. With the education and partnerships that we create
in the communities that we work, our enforcement efforts are
going to be so much better.
So the Meth Watch kits, even though we didn't get the
turnaround necessarily from the meth cooks we did, we got great
relationships that we built within the communities that offer
us very good information about what is going on and where to
focus our enforcement efforts. So I think those--the
interdisciplinary is very important.
Chairman Bucshon. Dr. Maxwell?
Dr. Maxwell. Thank you. In listening to the testimony and
in preparing my presentation, I think one of the things that is
very, very important is we have a lot of data out there but it
is accessing it and thinking about it and do things change as
we do bring research? What does that mean for the user
population or the statistics on what sources--are they shifting
from methamphetamine to something else?
It is always looking at little pieces of data, but when I
start pulling it together and I think particularly with the
Committee's support for going much further in dealing with
methamphetamine, we ought to be able to sit down and say we
have made progress here, we are not making progress there.
One of the problems that we have now is that after the
pseudoephedrine limitations started, everybody declared we had
won the war and gone home and we don't need any more
specialized methamphetamine treatment. They weren't looking at
the data. So I am a data nerd but I think it tells us often
where we need to go and where we have missed the ball.
Chairman Bucshon. Well, I would like to thank all the
witnesses again for their testimony. This is been a fascinating
hearing. And I think from my perspective I do think from a
research perspective it is very important that we continue to
make sure we have Federal support for basic research in all of
these areas, as well as other--through National Science
Foundation, which is under the purview of this Subcommittee and
other agencies such as the NIH.
I also think it is important probably to have a national
strategy on this type of work because in Indiana if you put
laws in place for one thing, and the states around you don't,
or if the States around you put a law in and you don't, it just
gets transferred across the state, especially in Evansville
where we have Illinois, Kentucky, and Indiana. So I do think it
is appropriate to discuss the national strategy and attack this
particular issue in my opinion.
With that, that ends the hearing and the hearing is
adjourned.
[Whereupon, at 11:33 a.m., the Subcommittee was adjourned.]
Appendix I
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Answers to Post-Hearing Questions
Responses by Dr. Edythe London
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Responses by Dr. Jane Maxwell
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Responses by Dr. Celeste Napier
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]