TREATMENT EXPERTS

DR. ROBERT DUPONT

Tell me about your August, 1969, study in the prisons. What was it, and
what did the results say to you?

The study we did in the prison really changed the way the city thought
about the [crime] problem, and changed the way I thought about the problem.
It was a dramatic development. Essentially, I had observed from working
with prisoners that a lot of them had problems with heroin addiction, and
that very little was being done about that. . . . So the question was, how
big is this problem? I got a group of unemployed college students. We went
down to the D.C. jail with our urine cups, and collected urines from
everybody who came into the jail for the one-month period of August, 1969.
When we found that forty-four percent of them were positive for heroin,
this was remarkable to everyone. Even more importantly, we asked the people
not only did they use heroin, but also, when did they start using? And what
we were able to show is that the crime rise, the crime epidemic, was
directly tied to the rise in heroin addictions in the city. That link was
very important to everything that happened afterwards.

At that time, what was the drug problem considered to be?

The establishment at that time, in mental health and in public health, was
very dismissive of "the drug problem" and saw it as a very minor problem.
There was a problem of LSD at that time. Marijuana use had hardly begun.
Heroin was clearly a problem. People were using cocaine at that time. But
even in 1960, this country focused for a long period of time on heroin
addiction, going all the way back to the beginning of the twentieth
century. So that was a special drug--there was no doubt about it at that time.

But I think the most striking thing was the trivialization of drugs by
almost all of the experts. If you go to the National Academy of Sciences,
or the Public Health Service, or any establishment or the health department
in the city of Washington, and ask them about the drug problem, it was
dismissed as not very important. The most striking thing we had to deal
with was [to show] that this was a serious and large problem. Then the
second step was that we had to show that something could be done about it.
But the biggest step was to show that it was a serious problem, because it
was dismissed as--not just a fad--but a sort of media hype, a bunch of
know-nothings who were overreacting to a trivial blip. Like the Hula-Hoop,
it was not very important and it would pass away in very short order. That
was the intellectual environment in which this took place. . . .

After you've done this study in the prisons, you got motivated to start the
NTA [Narcotics Treatment Association], and you get the sign-off from D.C.
Mayor Walter Washington. Tell me what you hoped to do.

We began the first methadone [treatment program] in the Department of
Corrections in September of 1969. It was a very exciting time. I remember
going down to the jail and putting together our first group of patients,
getting them started on methadone. It was ten or fifteen people. It was a
very small operation, but it worked. The patients did well. We were able to
hold it together and make it go. We had an extremely favorable relationship
with the Senate District Committee, which was headed by Joseph Tidings, a
Democrat from Maryland, [he] decided that he wanted to take this into a
citywide program. . . .

I was studying for the boards to be certified as a psychiatrist, which is
what you do after you finish your training--you have to have two years of
experience. As soon as I got the two years of experience, I . . . went out
to San Francisco to take the boards. And when I got off the plane from San
Francisco, I came home and watched on the television a press conference
that very day. Mayor Walter Washington announced, while I was in-flight
from San Francisco, that this new agency had been formed, and that I was
going to head it, and it was going to make a huge difference for the city.
. . .

Once you'd been appointed to all this, and gotten it all underway, could
you tell me about this interesting call you got from Bud Krogh to come into
his office? Tell me about that first meeting and first call.

The thing that was most striking about it to me was that we were all quite
young.

. . . but it was a very serious group. . . . My sense, right from that
first meeting, was that he was very concerned about what was going on, and
really wanted to have things be right, and that that was very important. He
was very interested in a vision of being able to think about where this
might go, and how that might happen, and what results could be reasonably
expected. Those were definitely part of what went on. But my sense of it
was that it was serious people doing serious business. . . .

There were a couple of things that the Nixon campaign and administration
had set as priorities that made this possible. What were they?

Nixon had really made a big deal about crime in general, and crime in
Washington in particular. He had said he was going to make things better.
And when he came to office, he had a lot of other things he was interested
in, and this was not important to him at all. And so he just ignored it. It
was a group of local citizens--Edward Bennett Williams and Katherine Graham
were very important--who went down to Nixon personally, and said, "We're
going to hold a press conference every week and quote what you said you
were going to do, and show what's really happening, and we're going to
embarrass you until you wake up."

It was at that point that Nixon said, "I committed myself to do this. What
I said is very public I have to do it." And he turned to Bud Krogh and
said, "Make it happen. I don't know how." There weren't a lot of
alternatives. The most visible was putting police on the streets, and they
did that. And I think they did a pretty good job. Jerry Wilson was a very
impressive chief of police.

From a political point of view, Nixon never really got a hold of drug
treatment as an issue, because it just didn't play well politically for
him. And so he never really grabbed a hold of that. Whenever there would be
a new statistic about things getting better with crime, once they did get
better later, he would never have me standing next to him--it was always
Jerry Wilson. He was very clear about what image he wanted to portray. But
behind the scenes, it was very clear that drug treatment was an extremely
important part of what was going on, and what the White House was
interested in. . . .

And the NTA got a lot of criticism about methadone treatment?

Methadone was just horrible from a political point of view, just a total
disaster. It was an orphan from beginning to end, and it is today. I think
the simplest way to say it is that it's an addicting drug. How can you
treat addiction with an addicting drug? At the end of the day, you're not
going to make that sale. It's not going to happen. So we never got over
that problem, and it was always pushing a rock up a mountain, only to have
it fall back down on you over and over again. . . .

I remember meeting one of the leaders of Washington society, who was a very
famous man. I'd seen his name in the news for years, and to meet him and
his wife at a reception, I was very proud. I was very much in the news at
that time and so he introduced me. He had known me from some context to do
with NTA, and he introduced me to his wife. She spit on me and said she
wouldn't talk to me, wouldn't shake my hand. And I was dumbfounded by that.
What happened? I never met her before. And the answer was that she was
really upset about methadone, and to her, I was the guy who was bringing
methadone to the city, to the country and she was registering what she felt
about it. That was very shocking. . . .

But it was much more difficult even than that. Nixon was tremendously
unpopular, especially toward the end, especially with the human services.
The kind of environment in which we live was full of people who had
animosity toward Nixon. The fact that we were associated--that methadone
and its expansion was associated with Nixon--that was a tremendous problem.
And then there was the racial aspect of it, which was very difficult for me
to deal with. Ninety percent of the patients were black. The city was
seventy-one percent black, and I was obviously white. There was a charge
that this was racist, that this was a form of enslaving the black, young
men in the nation's cities. That was, I think, the most vicious of the
anti-methadone kind of arguments. . . .

Another time, I was on the Howard University radio station. I was talking
with a young black man was the deputy head of the local competing drug
treatment program. He and I were talking, and he announced that the
community had to get rid of people like me, and that he was recommending
murder--that I be killed because of what I was doing to the community. The
host of the show acted as if this was a normal kind of conversation. And
this was on the air. . . .

It was a pretty painful experience for a young guy who saw himself as
trying pretty hard to do something helpful--to realize that, to an awful
lot of people, I was only a symbol. And it was not a symbol they liked, and
it didn't matter what I said. . . .

What did methadone symbolize that was so terrible?

Enslavement. It was enslaving the black underclass. It was robbing, it was
the narcotic, the opiate of the masses, being given out by the government
for political purposes, to make docile the revolutionaries who were
otherwise going to free themselves and change the society. That's the way
people thought, what some people thought. And it was done for political
purposes. I was the agent of Richard Nixon and it was anti-black,
anti-poor. . . .

But the epidemic was stopped cold in 1972. That is so amazing, how you see
30 years later, that was one experiment that seemed to work.

We started NTA on February 18, 1970, and we had a goal of treating all the
addicts in the city, with the goal of having an impact on heroin addiction
and crime and life in the city. And the most remarkable fact about it is
that we did it. The crime rate was cut in half, and heroin overdoses almost
ended in the city. We couldn't find addicts to get into treatment by 1973.
It was an experiment that worked, and it worked to a very high level, way
beyond anything anyone could have imagined. It went on to have a profound
effect on national policy. That's the good news.

The bad news, and something that I struggled with, is how it was lost. What
happened in the city was just gone. It became an orphan in the city
government. Nobody cared. And the rates then went back up again, the crime
rates and the addiction rates and the people who are there don't even
remember that. It's like it never happened. I think the saddest thing to
think about is how when you're successful in dealing with the drug problem,
you go back to where you were before, and then it's not an issue. And when
it's not an issue, there's no money, there's no program, there's no
activity. That is the inevitable fate when you're successful.

I'm interested in the "D.C. lab" and how all these young men were working
together. You were saying that Krogh had an idea, and Nixon had an idea: to
just get it done. What was it like to be in that lab in those first couple
of years?

The concept that what we were doing was a lab for the federal government is
a retrospective concept. None of us set out to have a lab. It just happened
that way. What I was doing was really something very local, and really was
deeply rooted in the local community, and everything that was going on. The
vision that this would be of national significance was very secondary to
me, and to everybody I knew who was working in that program. . . . We had
lots and lots of problems just one day to the next. We weren't talking
about being a national laboratory. I would see Bud Krogh once a year, maybe
twice a year. He was not an important part of my life. . . .

Was there a drug epidemic in our country at this time?

The most important development in our culture that made all this happen was
the great drug epidemic that started in the middle-1960s. It just grew and
grew and grew, and peaked at about 1978, 1979, and then had another little
spike around crack cocaine. It has come down somewhat since then, although
it continues at levels much above what the pre-epidemic was.

And the question was, why did that happen? What made it happen? One reason
it happened was because drug use got very caught up with the youth culture.
So drug culture and youth culture became virtually synonymous at that time.
And the drugs were just not a matter of having pleasure. Drugs were a way
of consciousness expanding. You could see and think and feel things with
drugs that you could not do without drugs. You were entering a new and
magical land through the use of drugs. People like Timothy Leary were
extremely important in terms of giving drug use a meaning beyond just pleasure.

They also were a way of thumbing your nose at older people, at established
authority. It was a way of marking you as different from those other
people, who didn't get it. And that was terribly important also.

Now, behind all of this, why that happened is the simple explanation of the
baby boom getting into adolescence and young adulthood. When that happened,
there was a profound cultural shift. The older population, which would
normally be responsible for young people and their behavior, was filled
with self-doubts. It was not ready to jump in and take over in that
situation, but kind of walked off the playing field. And so there was this
out-of-control development in the late 1960s, and drugs were a very, very
important part of that whole process.

Now, within that, it's very interesting that heroin played a very specific
role. Heroin started early in the epidemic. Heroin was before marijuana,
which people have a hard time imagining. And it was in the inner cities
among poor people, and it was intravenous, IV, heroin use. It started in
1966, and it peaked between 1969 and 1971, which is extremely early.
Cocaine didn't peak until 1987, 1988, 1989. Marijuana didn't peak until
1978 or 1979. Heroin peaked very early in this very specific population. It
had devastating effects in those communities--not in the suburbs--but in
those communities, it created a tremendous increase in crime, overdose
deaths, disruption of the communities. One of the reasons the epidemic
stopped was because it was horrible. It was demonstrably bad. . . .

How did national attention get turned to the drug problem in Vietnam?

In the spring of 1971 . . . two congressmen, Steele and Murphy, went off to
Vietnam, and they came back with explosive news: that ten to fifteen
percent of the servicemen were addicted to heroin. They were coming back to
the country by the thousands, bringing their addiction back, and the only
solution they could see was to pull out of Vietnam. . . . That was what
moved this issue to the front burner. It wasn't crime. Crime got it
started. But what moved it to the front was Vietnam. You can have no doubt
about that when Jerry Jaffe was appointed the first White House drug czar.
The day of his appointment, he was on an airplane for Vietnam. So it was
very clear what the primary focus was.

Your numbers were coming back in a pretty interesting way during the period
before and after the 1972 election. Tell me what your numbers were showing.

The crime rate in the District peaked in the fall of 1969, and fell. By the
time of the election, the crime rate in Washington was half--a fifty
percent reduction on a monthly basis for the FBI Index crimes. That was
phenomenal. That was a phenomenal change. And it was contrary to the rising
rates in the rest of the country. We had these declining rates, and it was
hard not to think about the fact that treating all those heroin addicts had
a very big impact on that.

But there were also other indicators. Overdose deaths were way down, and in
the end, even demand for treatment was way down. We got so far into the
heroin population that our intake rates even declined, because we were
running out of untreated heroin addicts in the city. That was quite a
remarkable thing to think about. So that was happening. And the question
was, how can that be used in terms of a national initiative, and be done in
a way that would have an effect by the time of the election? . . .

After the election, Donfeld, Krogh, they all went off to different jobs.
And then there was the specter of Watergate. What did it feel like after
this huge push, after this exhilarating . . .?

Nixon had decided that second terms tended to run downhill, and the way he
was going to counter that was to change his team. So he was going to move
all the players, and a lot of them were out. I thought it was very sad. A
lot of the people who had worked very hard for his election suddenly found
themselves out on the street, and other were moved into new places. It was
pretty tough situation for a lot of those people.

Now for me, it meant moving from the city government to become the second
White House drug czar. In a way, that was wonderful. I was a much bigger
bureaucrat than I had been before. But it was not a step up for me. I
missed what I had before. And when I think back on it, if, if I could do it
all over again and have it my way, I would've stayed in the city
government. I could have a lot more effect there in developing a model for
treatment and making this thing work than I ever could at the federal
government.

I remember the first hearing I had before the Senate. Mind you, I had
testified before Senate committees maybe hundreds of times, certainly
dozens of times. This was not a big deal for me. But I was now talking
about different issues. I was talking from the federal government's point
of view.

And so the question was, what do we know? How many people are in treatment,
and what kind of treatment, and where are they? I had done a lot of
figuring out the numbers at NTA. So we had a very expensive, computer-based
system to report on drug treatment in the United States. The staff person,
who was a very high-level person, plunks this report down on my desk and I
look at this thing. A lot of the things I know because I know the people
who are running the treatment programs in most of the cities. . . .

So I said, "How confident are you in these numbers?" "Oh, yeah, these are
the numbers. This is the way it is." And I realized that person had no
clue. He had never seen a heroin addict in his life. He'd never been in a
drug treatment program. To him, every number was like every other number.
And he was going to send me up to testify before the Senate with those numbers.

Okay, now I understand where I am and what I'm dealing with. I got on the
phone, and I started calling around to get my numbers from the people who
actually knew what was going on. I went to testify, and I didn't use their
computer-generated numbers. I used my numbers, because they were right and
those other numbers were wrong.

And I had that experience over and over again, with people who were just
remote from the problem, who had been there before this had ever started,
and would be there afterwards. They were just putting in their time. It was
a totally different culture than I had been in before, and one that I did
not like, and didn't feel comfortable with it.

So it was very difficult. It was also difficult because the Watergate
scandal just sapped strength from the Nixon administration. It was like
every week was worse than the week before, in terms of being able to focus
on things and get things done. And that was a very, very grim situation.

Then Nixon left. Gerald Ford took over, and . . . made a decision that it
wasn't in his political interest to push the drug issue, that there wasn't
anything there for him. He was facing an election practically as soon as he
came in, and this wasn't part of the mix. So my job was to close up the
White House drug office. I went from 168 [staff] to zero. . . .

Under the Ford administration, there was the White Paper. Tell me about the
short- and long-term effects of the White Paper.

There had been interest in thinking more broadly about the nature of the
drug problem, and the White Paper embodied that thinking. It reflected
sophisticated judgments of the time. Basically, those were all about the
fact that heroin was a serious problem and marijuana was not a serious
problem. The way you knew that was that heroin had overdose deaths, and had
crime associated with it. Marijuana was a political issue. It was a bunch
of moms in the suburbs who were unhappy about their kids' rebelliousness.
And that was not a serious problem.

The federal government was way outside its normal role in terms of
providing healthcare services--the federal government doesn't do that. So
doing that in drugs was very unusual. The idea was to narrow that focus
down to the serious drug problems, and the serious drug problem essentially
was heroin. What was very striking about the White Paper is that it
dismissed marijuana and cocaine as "not serious." And that was not a
judgment that Gerald Ford made--that was made by his drug experts. . . .

But I certainly participated in that, and it reflected my thinking at that
time of what was the nature of a serious drug problem. It was an attitude
about drugs that had gone back a long period of time, well before the Nixon
administration. But it was expressed very clearly in that White Paper. Of
course, looking back on it, it's a terrible embarrassment, because it
failed to understand the nature of addiction. It failed to understand not
only the current status of the marijuana and cocaine problem, but the
potential of those problems. And rather than being sophisticated, it looks
just phenomenally dumb today. . . .

Tell me about the evolution of your position on decriminalizing marijuana.

When I came to the White House, Richard Nixon said, "You're the drug
expert, not me, on every issue but one, and that's decriminalization of
marijuana. If you make any hint of supporting decriminalization, you are
history. Everything else, you figure it out. But that one, I'm telling you,
that's the deal."

Since I thought marijuana wasn't very important, I was pretty happy to
accept that deal. Later on, I grew restless under that restriction. And
when Gerald Ford was president, the first thing I did as White House drug
czar was come out for decriminalization of marijuana. I spoke at the NORML
conference, and even went so far as to say that it's not just possession,
but also growing small amounts for personal use that ought to be
decriminalized. That got me a big play. My recollection is the cover--but
I'm not sure about that--in High Times magazine.

And it's interesting, because at the time I knew marijuana was not good.
And I always spoke about the health hazards of marijuana. I never said it
was benign in the sense that it was safe. But I would balance that health
message with a message that says we don't want to use the criminal law to
try to solve a public health problem. We'll do this by education. It was
called a policy of discouragement. You wanted to have a non-criminal policy
of discouragement.

Now, what I didn't notice--it took me a long time to notice--was the only
thing anybody heard was that I was pro-pot. It took me a couple of years to
figure out that, no matter how many caveats I put in there, no matter how
careful I was with my language, when it got to the sound bite on the
evening news, the only thing they played was that the White House drug czar
is pro-pot. That weighed very heavily on me eventually, to think about it.
But the initial enthusiasm for it was that this was breaking new ground,
and that I was doing something that was forward-looking and very positive.
. . .

Tell me about the "mad housewife" letter that Keith Schuchard sent you.

I'm the know-it-all head of NIDA. I get letters from people, and I read the
letters. I didn't get that many letters. And I read this letter. My
recollection is it was two pages. . . . But I looked at that letter, and I
said, "She's right and I'm wrong." It wasn't hard for me to do that. I
could see that. She made a very simple point that I still think is very
profound. She said, "When we're talking about marijuana, let's distinguish
between marijuana use for kids and marijuana use for adults. There's nobody
who thinks it's a good idea for kids to use marijuana, including NORML."

I had never made that distinction before. Marijuana was one thing. It
wasn't adults versus kids. So that was really very striking. She also made
very clear that support for decriminalization was seen as being pro-pot,
and that that had a very negative influence. It had a negative influence in
her life, and a negative influence in people's families' lives across the
country, and I was personally responsible for that. That really hit home. I
thought she was right about that.

There were other things that had happened at the same time. There was a
Senate hearing. Senator Eastland held hearings that were very convincing
about the negative effects of marijuana use. The rapid rise of marijuana
use by high school seniors was very striking, and quite scary to see.
Meanwhile, all of the experts on marijuana at NIDA were filled with, "It's
not a big deal, it's not a big problem." There wasn't one person I knew in
the scientific community, at NIDA anyhow, or in NIDA's grantees, who
thought that Keith Schuchard was right.

So I had to walk away from all of the scientific experts that I had some
respect for, although over the years, I must say, diminished respect. This
was a real turning point for me. When I went down to Atlanta and met with
Keith and her group, it just turned me around. I had a different view of
marijuana. And basically, the simple way to say it is that I realized that
these public policies were symbolic--all that really mattered was you were
for it or you were against it. All these fine distinctions that were being
made weren't registering. I think about it as a litmus test--where are you?
And at that time, the litmus test was decriminalization. "What do you think
about decriminalization, Dr. DuPont?"

And if the answer was, "I think that's a good idea," you put an X in the
pro-pot box. If I said, "Decriminalization is a bad idea," you put an X in
the anti-pot box. Everything else was irrelevant. And so I said, "I'm going
the other way. I'm changing my mind." By that time Jimmy Carter was
president, and all of a sudden, I've got a president who says, "You can't
be opposed to decriminalization, because that's my policy." I had come full
circle. I started with a president who says I can't support it. And now
I've got a president who says I have to support it.

So when I left the government in 1978, the first thing I did was have a
press conference and say, "I was wrong. I made a mistake. Decriminalization
is a bad idea. Marijuana is not non-addictive. In many ways, it's the worst
drug of all the illegal drugs." That was a dramatic departure, and I
haven't wavered since, although many of my friends on that side of the
argument are always waiting for me to go back the other way. I switched
once, I might switch again. I don't think that's going to happen. . . .

How would you evaluate the current situation with drug abuse and our drug
policy, having been involved for 30 years?

The problem is the drugs really work. People really like drugs. It doesn't
have to do with advertising. It doesn't have to do with slogans or any of
that sort of thing. It has to do with the brain. And that the drugs really
work. And they work better for some people than others. The vulnerability
is not equal in the population. There are many factors, including genetic
factors, which influence that vulnerability. But the most important
determinate is the environment in which people and drugs come together. And
the more permissive that environment is, the more you're going to have drug
use. And the more you have drug use, the more you have drug problems.

So to me, the game has always been reducing the levels of use. That is the
objective. And there's a big war going on right now about whether that is
the objective or not. But from my point of view, that's what it is.

And so when I look at a drug policy, I ask, "Does it reduce use, or does it
not reduce use?" That's the most important question. . . . And what's
happened over this 30 years is that politicians have come and gone. Drug
czars have come and gone. People come on the stage and play their roles and
go away. But the enduring problem we have is that we have a society that
prides itself on diversity, prides itself on privacy, prides itself on
individuals making decisions for themselves, and we are confronted with a
drug problem that tends to be tremendously magnified in exactly that kind
of environment. And the question is, how do we then create, for the first
time in world history, a social response that respects the fundamental
values of the society, and also is realistic about the nature of the drug
problem? What you see, I think, is this incredible struggle with these
conflicting forces, and to try to find some answers to that.

I'm far from saying that this drug war has been lost. I think the drug war
is being won--not as well as it might be, and it's sure not a slam-dunk.
But if you just look at the levels of use in the society, they have come
down since 1985. And that's something people need to feel good about. . . .

PBS Frontline Series Follow Up by Tom O'Connell, Kevin Zeese, Doug McVay,
and Eric Sterling:
http://www.drugsense.org/dsw/2000/ds00.n170.html#sec1

Campaign for the Restoration & Regulation of Hemp's HempTV website has the
full, two part, total of almost 4 hours of video of the PBS Frontline "Drug
Wars" available on the web for free video streaming using the Real Player 8.

To watch Part one of Drug Wars, go here:

http://www.crrh.org/hemptv/docs_drugwars1.html

To see part 2, go here:

http://www.crrh.org/hemptv/docs_drugwars2.html

Click this link for an index to this series:
http://www.mapinc.org/drugnews/v00.n1551.a01.html