Letter to President Elect Obama Regarding the Selection of our Next Drug Czar…From Substance Use and Mental Health Treatment Professionals

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Dear President-Elect Obama,

As substance-use and mental-health professionals treating patients with substance use disorders, we are concerned about reports that President-elect Obama is considering Congressman James Ramstad as our next “Drug Czar,” or director of the Office of National Drug Control Policy. This country needs a Drug Czar who supports evidence-based policies and one who will make decisions based on science, not politics or ideology. We strongly believe that Congressman Ramstad is not that person.

While we applaud Representative Ramstad for his courageous and steady support for expanding drug treatment access and improving addiction awareness, and honor his own personal and very public triumph over addiction, we have strong reservations about his candidacy for the Drug Czar position. In his twenty-eight years in the U.S. House, Rep. Ramstad has consistently opposed policies that seek to reduce drug-related harm and create common ground on polarizing issues.

Rep. Ramstad voted in 1998 in favor of making permanent the federal funding ban on syringe exchange. In 2000, he voted to prohibit the District of Columbia from spending its own locally-raised funds on syringe exchange programs, and in 2007, he voted against lifting the same DC ban, despite decades of research showing that syringe exchange programs reduce the spread of HIV/AIDS, save lives, save money, and do not increase drug use. Rep. Ramstad has also consistently opposed congressional efforts to stop the arrest of patients with HIV/AIDS, cancer, and other illnesses who use medical marijuana to ease their pain and suffering in states where it is legal.

Unlike you and Vice-President-Elect Biden, Rep. Ramstad has also failed to cosponsor any legislation eliminating the sentencing disparity between crack cocaine and powder cocaine, despite the fact that there were three different crack/powder reform bills in the 110th Congress. A number of recent studies have found that long prison sentences are one factor driving disproportionate rates of HIV/AIDS infections in communities of color. A primary task of the next Drug Czar should be to deal with this and other issues related to over-incarceration.

We need someone committed to reducing the harms associated with both drugs and punitive drug laws. Someone who supports:

1. Treatment interventions across the spectrum of readiness to change such as: Recovery Readiness, Motivational Interviewing, and other interventions which do not require abstinence for active substance users just beginning to work on their substance use; substitution treatments like methadone and buprenorphine (the most proven effective treatments for opiate-dependent patients); and abstinence-focused in- and out-patient treatments for those working toward abstinence and recovery.

2. Integrated treatment for patients with co-occuring psychiatric, medical, and lifestyle disorders – a group that makes up the majority of patients with serious substance use disorders.

3. Syringe exchange programs to halt the spread of HIV/AIDS and hepatitis C,. This is an intervention that has been proven to dramatically reduce the transmission of infectious disease and reduce drug use in the injecting population without increasing drug use.

We need a new bottom line for U.S. drug policy so that treatment is more available and addiction is treated like a health issue, not a criminal issue. To paraphrase former Baltimore Mayor Kurt Schmoke, we need a surgeon general not a military general or police officer.

We need a Drug Czar who welcomes and encourages new ideas and research. We need a Drug Czar who is committed to reducing the number of nonviolent offenders behind bars. Our country's next Drug Czar should be fully committed to major sentencing reform. There should also be greater emphasis on educating our judges, prosecutors, and parole and probation officers to the complexities of substance use disorders and the process of change and recovery. When patients in treatment for substance use disorders "slip" it is more the norm than not; as an expected part of the process of change, it should not lead to automatic termination of treatment and incarceration. These decisions need to be made in conjunction with the clinical staff working with these patients who have the expertise to make them.

We need a Drug Czar who understands there are many roads to recovery and recovery can take different paths. We strongly believe that our views are in the best interests of individuals struggling with substance use disorders and all Americans and will be considered in your choice of the next Drug Czar.

Thank you.

Sincerely,
Andrew Tatarsky, PhD
Founding Executive Board Member and Past President, Division on Addictions, New York State Psychological Association

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