Press Briefing Via Conference Call by Director of the Office of National Drug Control Policy, John Walters, on the 2008 National Drug Control Strategy (Text Only)

Press Briefing Via Conference Call by Director of the Office of National Drug Control Policy, John Walters, on the 2008 National Drug Control Strategy

DIRECTOR WALTERS: Welcome to everybody on the call. I will just give a brief summary, and then I'll be happy to take your questions on any of the topics we touch on, or others related to the drug control strategy.

As the President mentioned, we begin the 2008 strategy release with the progress that's been made from a lot of hard work throughout the country: 24 percent decline in teen drug use since 2001, approximately 860,000 fewer young people using drugs today compared to where we started; youth marijuana use within those numbers dropped 25 percent; ecstasy is down by half, and meth, as he mentioned, down by 64 percent.

In addition, we have seen in the last year disruptions in the national meth and cocaine markets on the supply side -- cocaine shortages reported in 38 cities. Increases in price and purity demonstrate that the volatility of those markets has been sustained -- or that reductions in the volatility in the prices shown in those reductions has been sustained under effective pressure on supply that hitherto was not possible.

The strategy outlines a balanced approach, beginning with prevention. It continues to utilize effective tools, such as the Youth Anti-Drug Media Campaign; also non-punitive, random student drug testing programs, workplace drug testing programs, and coalitions and drug free community efforts throughout the country.

To date, more than 80 school districts have received federal funds -- for example, for the U.S. Department of Education grants to develop or maintain random drug testing in more than 400 schools. In addition, many schools -- equal or greater number -- have been developing and implementing testing programs, we've found, with their own resources.

In regard to treatment, the President's Access to Recovery program, which is one of the first initiatives launched by the administration, has provided comprehensive treatment and support services to over 190,000 Americans who would otherwise have gone without treatment. It also showed that the addition of recovery support to the treatment funding is an enormously beneficial component, as we had hoped, in sustaining sobriety and recovery.

We have also implemented in more and more places, and are seeking to implement into the regular health care institution screening and brief interventions as a part of regular health care, to help break the cycle of addiction, to identify individuals as they come in for a check-up, a physical, emergency care, pediatric care -- whether or not they are using or abusing drugs -- at the primary health setting, and either through a brief educational intervention as we've done with things like hypertension, diabetes and obesity, or referral to specialized care, help use the medical institutions more fully to help break the cycle of abuse.

We've also, as you know, expanded supply control efforts, not only in sustained efforts in Colombia with regard to cocaine and heroin, but expanded cooperation with Mexico and a desire to expand that further, with requests by the administration before Congress for support for Mexico. And we have taken on, for the first time, during this administration the problem of opium in Western Asia and Afghanistan. These programs are new, and in terms of the ones in this hemisphere, we've had remarkable change for the better in supply of drugs in the United States.

As the President also mentioned, prescription drug abuse is a growing concern. While overall drug use by youth have declined, 2 million teens abuse prescription drugs, and the estimates are that 2,500 young people per day initiate use -- abusing prescription drugs. They are now the top source of abuse for young people ages 12 and 13, for example. Seventy percent of youth users say they get them for free from family or friends, usually out of a medicine cabinet directly or indirectly in the homes of those family or friends.

We are encouraging parents to safeguard these prescriptions when they are in the home for legitimate purposes. We obviously want people to have access to these. They're largely -- we're talking about prescription painkillers -- are the most overwhelmingly most abused substances. We also need to control access to them in our homes when we're through with them. There's a lot of, we find, prescriptions that are not any longer being used, the purpose has ended, but they are not discarded. We're encouraging people to discard them, and we're also encouraging people to make sure they talk to young people about prescription drug abuse, because there's a great deal of misunderstanding that's contributing to the use and abuse by young people.

Online pharmacies have become a source of prescription drug abuse. If you have an email account, in the last several years you've undoubtedly been spammed by somebody offering controlled substances without the control. Some of these are -- not all of them are frauds. Some of them are real. In calendar year 2006, just 34 known or suspected rogue Internet pharmacies dispensed over 98 million dosage units of hydrocodone, all of which was diverted. The maximum amount of legitimate prescriptions, on average nationwide, is about eight pills per day.

Therefore, these 34 pharmacies dispensed enough hydrocodone to supply over 410,000 patients for a month. The average pharmacy dispenses about 88,000 dosage units of hydrocodone. Therefore, it would take the entire annual sales of hydrocodone from 1,118 pharmacies to equal the amount dispensed by just these 34 rogue Internet pharmacies. The damage can be done on a wide scale, in other words, by a relatively small number of criminal actors here.

The President is calling for tighter controls on online pharmaceuticals. As he mentioned in the radio address this morning, we are urging Congress to take swift action on legislation to end illegal sales of controlled substances of prescription drugs on the Internet. The Ryan Haight Online Pharmacy Consumer Protection Act, S.980, sponsored by Senators Dianne Feinstein of California and Senator Jeff Sessions of Alabama, would restrict the ability of rogue Internet pharmacies to illegally divert dangerous controlled substances and prescriptions to millions of people, even teens, without valid -- it requires valid prescriptions issued under a legitimate physician's care. The bill has been given unanimous support in the Senate Judiciary Committee, last September, and awaits consideration by the full Senate.

The overall efforts that have been marked by today's strategy release are obviously the result of many parents, educators, community leaders, public safety personnel throughout the country, as well as those serving abroad and foreign allies. We are pleased to be able to reinforce those efforts and our real task, as the President mentioned, is to follow through. With that, I'll be happy to take any questions.

Q Good morning. I'm a reporter working for AFP for Latin America. And you may know we have reports this morning that the number two of the FARC, the guerilla in Colombia, has been killed by the Colombian army, and I would like to know if you can give us a reaction on this information? And also in the report of this yesterday, these reports criticize the efforts of Venezuela on the fight against drugs. I would like to -- you to elaborate on that, if it's possible. Thank you.

DIRECTOR WALTERS: Yes, on the first part of your question, I don't have any current information, so I can't offer you any comments at this time.

The issue of trafficking from Venezuela has, as you probably know, become much graver in the last several years. The movement of drugs, by air going north from Venezuela in particular, into Hispaniola, primarily into the Dominican Republic, has grown and threatens not only the well-being of the people on the island of Hispaniola, but obviously moves dangerous flows of drugs into the Caribbean, which had been a thing of the past, and obviously is a great danger to the safety and stability of those countries.

In addition, increasing quantities of drugs have been found leaving Venezuela by sea and air for Africa and for Europe, principally cocaine, and we have been working to try to break that movement by allying with not only Caribbean nations, but also European nations, which are the ultimate victims of this flow. We had continued to work -- try to work with the Venezuela government and President Chávez to try to stop this.

As you know, he has failed to continue the cooperation with our Drug Enforcement Administration several years ago. He has failed to take some of the steps that are obviously within his power. Many of these air flights appear to be coming from not clandestine, remote strips, but controlled airports where authorities could establish control, and it simply has not been done.

Obviously this is not good for the people of Venezuela, the corruption, crime, the violence you see growing in Venezuela today, and the victimization that inevitably follows drug trafficking is showing itself in Venezuela at a growing rate. We, again, continue to stand ready to work, but this is a problem, a transnational problem that requires good faith on the part of those who are affected, and so far we have been unable to get a modicum of cooperation.

I will also point out that we had a cooperative relationship in some ways up to about several years ago with the Venezuelan government. We have many governments that we work with on drug control who we may have political differences with or some other differences with. This is such a scourge to all nations that even those of us with differences in the international community have found it important and possible to work together. We hope the Venezuelan government will allow that to happen, but the rate of growth is a huge danger, and a growing danger to Venezuela, to Europe, to the Caribbean, and obviously to the United States.

Q Hi, thanks for taking this. You talk about routinely going after rogue pharmacies that sell drugs over the Internet. Maybe I missed it, but could you walk me through what sort of enforcement mechanism you think will be effective in getting these companies that are selling these drugs over the Internet to teenagers -- what practically can be done to stop them? What sort of enforcement mechanism is there?

DIRECTOR WALTERS: Yes, one of the things that's in the legislation focuses on what's called a valid prescription; that is that some of these pharmacies have used an anonymous contact over the Internet to a physician who is -- does not know the patient, does not know the individual, receives some kind of communication from the Internet in writing, and then on the basis of that, prescribes very powerful medications that can be abused in significant quantities, obviously.

One of the things this does, it describes what a legitimate relationship, medical relationship is for the purposes of writing prescriptions of these controlled substances. That means that, in short, the physician or a covering physician in the practice, in order to write a prescription, has to have had a -- at least one face-to-face contact with an individual. Now there are provisions in the legislation that allow people in remote sites who can benefit from tele-medicine to do so, but in addition, we are increasing the need to identify where these individual pharmacies and some of the administrative apparatus to make them run are. And thirdly, we are increasing the penalties for those who engage in violating these rules and seeking to circumvent legitimate prescribing practices.

So part of this has been a whole loophole in the law that has allowed people to pretend to be writing legitimate prescriptions without actual legitimate patient-doctor relationships, and also the Internet obviously allows you to be in a variety of places in order to conduct business. And what we're asking is -- and there are sometimes brokers involved in handling the communications, different sites involved in filling the prescription. We are requiring them to identify where they are more specifically, and in the case of true Internet pharmacies, there are some additional reporting requirements to be sure that diversion is not taking place.

Q If these pharmacies are located outside of U.S. jurisdictions, what sort of enforcement mechanism can you have on their access to their customers in the United States? Is there something you can do?

DIRECTOR WALTERS: There are limits on what we can do for those that are operating outside the law. However, I will say that most of the pharmacies that we have found, and the DEA has done cases on so far, have been in the United States or the Internet broker has been using a pharmacy in the United States to divert drugs. So right now we're looking at where the problem really is, and while there are some individual cases of controlled substance coming from outside the country, right now our problem is within our own borders for the most part, as we understand it, and we are acting against that part of the problem.

Other kinds of conspiracies and international trafficking, we do have some other tools at our disposal, but it is a different environment, obviously, than domestic enforcement.

Q Is this bill directed to the Canadian pharmacies and other pharmacies that older Americans are getting their drugs from, cheaper than they are in the U.S.?

DIRECTOR WALTERS: That's an important point. It's not directed at legitimate prescriptions. There is a different issue here, as you're alluding to, about acquisition of prescription medications outside the border of the United States. What we're concerned about is the diversion, for the purposes of abuse, of controlled substances, principally painkillers, but there are some others that are abused. And mostly that's within the United States, as I just answered, in answer to the previous question mentioned.

We've had to talk about some of the issues about re-importation and some of the others with congressional leaders, in working on the current legislation, but this is really about not whether -- how we legitimately obtain prescription drugs, even though there is a policy and debate about that, this is about what is criminal activity and abuse.

So this is quite narrowly focused. In fact, we have -- as I say -- tried to allow the benefits of things like tele-medicine or online access to prescriptions for people who don't have mobility. We want the benefits of the Internet to be continued for people who receive those benefits and may in the future. We want to stop the abuse, and as I indicated in the example I gave, a lot of this is not a few prescriptions on the side; what we're talking about is when -- as the investigations that have come forward indicate -- pretty clear criminal activity to divert pharmaceuticals under, in some cases, some of the loopholes in the existing regulations, and the pouring out of millions of dosage units. It's not a few pills around the side, it's not a problem of abuse in the stream of legitimate medication acquisition; we're talking primarily about intentional activity that is harming young people and adults, and we think we can, with proper legislation, cut that back significantly.

If there are any last questions, I'll be happy to answer; otherwise, thank you very much.

Q Mr. Walters, there has been some news reports in Mexico that some drug traffic organizations called for a truce to the Mexican government. This has been seen, interpreted, as a sign that these drugs organization is (inaudible) ahead from the Mexican government air force to combat these organizations. I wonder if you can give us your reaction, if these reports happen to be true, or at least what is the reaction of the U.S. government of the latest Mexican government efforts against drug trafficking organizations?

CHAIRMAN WALTERS: I don't know about the specific report that you mentioned, but I can tell you what our reaction is to Mexican efforts, especially under President Calderón. They have been historic and, as I noted in my opening comments, in addition to what we have been doing in cutting down production with President Uribe in Columbia and interdicting the flow of drugs coming up through the Atlantic and Pacific Oceans and Central American Isthmus, the additional pressure on these organizations that are -- have become powerful distribution points in Mexico and into the United States, the additional pressure we believe has contributed to the shortages of both cocaine and methamphetamine, which was manufactured heavily in Mexico, that we have seen now since early last year.

There's never been that kind of disruption on that breadth, for that long, in the United States. And I think that, more than anything else, is an indication of the pressure which these groups are. They cannot get product at the old level to addict people that they could before. We've seen the effect of that confirmed in declines in workplace drug-testing. We get some of these -- you may have seen the report last year from Qwest Diagnostics, showing unprecedented declines in cocaine positives in the workplace, to the lowest level they've ever seen since they've done consolidated testing going back to 1992.

Again, I think on both the supply and the demand side, we have already seen the enormous impact that the Calderón government has had in attacking these groups. Now, there's more to do. They are very dangerous. And, as you know, President Calderón has committed his government to the substantial resources and continued action against these traffickers on all fronts, and strengthening institutions. And President Calderón and President Bush have now prepared an additional and historic cooperative program, a merit agreement, funding that we're seeking to receive from Congress to allow the United States to help with things like information-sharing, secure communications, some mobility, some other kinds of infrastructure that we can help Mexican institutions develop faster while respecting sovereignty.

This is, as you know, this is new ground for our two countries, working together, respecting sovereignty, attacking a common problem that has been such a huge, huge plague to both countries; and doing it, at these stages, with remarkable success. I mean, attacking -- people thought you couldn't attack these organizations. Again, they're still powerful, they're still dangerous, there still is much more to do. That's why we want to make sure that we get the resources and do the support that is needed fully and as rapidly as possible, because it will be a watershed, obviously, for the people of Mexico and the people of the United States, and I think the people of the hemisphere, who have been harmed by this because it has spilled over into many countries in Central, South America, as well as North America.

Q I just wondered if the efforts that are being done in Mexico are making a difference already? And the second question I had is with regard to the online pharmacies. Do you think that the young people who are getting their drugs over the Internet might go to other sources, particularly street sources, if they're not getting them online?

DIRECTOR WALTERS: I'll answer the last part first. What we've seen is for young people, the principal source of access -- this is at the starting point -- is our own homes. Seventy percent of them, in the surveys that we use about youths and attitudes and behavior regarding teenage drug use, tell us that 70 percent of them get them from the medicine cabinets in their own home. This is a different problem from, say, marijuana or cocaine or heroin. The barrier is very low -- they're free, they're in the medicine cabinet of your own parents or your near relatives or your friends' parents and relatives.

They also -- kids tell us that they have a different -- they're partly led to this because they have been told that while street drugs are dangerous and made by criminal organizations and God knows what's in them, that pills are made by a regulated agency or regulated corporation in the pharmaceutical industry, and they've been told by irresponsible friends or by irresponsible information on websites that they or their friends have seen that if you take one of this pill and one of that pill, it's a safe high.

Now, again, keep in mind what they're referring to here is principally things like hydrocodone or oxycodone, Vicodin. These are extremely powerful synthetic opiates. They themselves can cause overdose death. In combination with alcohol, which is not an uncommon combination as you would suspect no doubt with teenage substance abuse, they can be deadly, and are in some cases.

What we need to do is, one, first, make sure we're talking to kids about pills, in addition to the other things we talked about, and correct what has been told to them, which is dangerous and false. Two, that the entry point for them is our own homes and medicine cabinets. We have to cut off the supply. We're the drug dealer; we have to stop being the drug dealer, if you will, by keeping these under our control, not leaving them unattended. Child-proof caps do not work for teenagers, we have to remember. Secondly, when we're done with them, throw them away.

So, again, I think this is a new hazard, but it's one where if we understand it properly, we can make change for the better quite quickly, in terms of the entry point. After people -- young people have entered, then the searching for drugs can lead more directly to online and to criminal sources outside the home and outside the free access of the medicine cabinet. The online pharmacy effort is one of those that we're using to go after this. We're also, obviously, going after places that divert these substances within the United States, because generally speaking, what we find is these are being diverted either through this online source or from other sources within our communities.

In regard to the question on Mexico, yes, we are working on the entire supply chain for cocaine from Colombia through the transit zone of Central American coast up into Mexico, the border, and domestically. The additional pressure by President Calderón that started over a year ago we believe was a decisive additional factor in causing the declines of availability of cocaine in the United States that started appearing about a year ago in the United States, and is now reported in 38 cities, and coupled with declines in positives in the workplace.

I should also mention, as you may know, there was increased use of methamphetamine after small toxic labs -- which have declined, thank God, throughout the United States -- making meth using over-the-counter cold and allergy medications. There has been -- there were reports that large quantities of meth were being made by Mexican organized crime, again, and moved into the United States.

The attacks on those groups by the Calderón government, and the attacks on the precursor being moved into Mexico from outside we believe have been far-reaching in their disruption of methamphetamine. Methamphetamine throughout the United States has now gone up dramatically in cost, purity has declined, and the principal source had become these organized groups. Mexico, as you may know, banned the importation of all pseudoephedrine and ephedra beginning January of this year, and next year it will ban all domestic sales of any products containing those substances, the precursor for meth.

So they've taken strong and far-reaching actions that have already resulted in saving lives in the United States, as well as Mexico.

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