Heroin trafficking : hearing before the Subcommittee on Crime and Criminal Justice of the Committee on the Judiciary, House of Representatives, One Hundred Third Congress, second session, September 29, 1994 online

developed. The cartels can provide stiff competition to Asian traf-
fickers and already sell very pure high-quality heroin in the United
States at a cheaper price than Asian counterparts.

Look briefly at Africa; Nigerian and related West African traf-
ficking organizations demand special attention because they move
a substantial portion of the heroin coming to the United States
from Southeast Asia. As you know, the United States did not cer-
tify Nigeria last year. I made an effort during my trip there in Au-
gust to convince the Nigerian Government that the United States
wants to certify them, but they have to earn it.

In the 3 months left in this calendar year, Nigeria needs to take
aggressive action. They were embarrassed by decertification and
have made an effort in recent months to extradite several
narco traffickers, and have voiced cooperation and support for our
heroin strategy.

Nigerian trafficking organizations dominate the drug trade be-
tween Africa and the United States. These organizations appear to
be global in scope, capable of effecting major capital flows to Africa
from other parts of the world, and able to influence the political ap-
paratus and economic functioning of Nigeria as well as other Afri-
can countries.



8

We must also work close with South Africa to help them oppose
criminal elements now setting up transit operations in Pretoria and
Cape Town. I was impressed during my visit to Pretoria by the co-
operative spirit of the South African police. I believe they can play
a significant leadership role in South Africa by providing training
and technical assistance to neighboring countries.

Since Europe is one of the largest world markets for heroin, the
United States will encourage European and other major countries
to take the lead in thwarting heroin production and trafficking in
Eastern Europe and the Commonwealth of Independent States,
providing these countries with antinarcotic assistance. U.S.
countemarcotics assistance will be provided through the UNDCP,
along with limited direct assistance for building indigenous law en-
forcement, demand reduction and money laundering enforcement
capabilities.

In closing, let me look at the next steps. Many of the initiatives
included in our strategy will not need increased funding, but we
will ask agencies and departments to make a realistic appraisal of
their counterheroin resource requirements for fiscal year 1996.
Currently, just over 10 percent of our international counter-
narcotics budget is directed against heroin.

Because the principal drug threat to the United States is, and is
likely to remain, the use and consequences of cocaine, we have fo-
cused the overwhelming proportion of our resources, programs and
activities on stemming the flow of cocaine to our country. However,
as the supply and purity level of heroin has risen, so has use. If
left unchecked, these conditions can produce another drug use epi-
demic in the United States that will cause more health problems,
more drug-related crime and staggering society and economic costs.

I am convinced that we must respond to these troubling trends
by doing a better job of providing education, maximizing preven-
tion, early intervention and treatment efforts, especially in cases of
heroin inhalation. We must also continue with efforts to identify
and treat the chronic heavy user population — those who use co-
caine, those who use heroin, especially those who use multiple
drugs.

Mr. Chairman, that is my testimony. I would be glad to respond
to any questions.

Mr. SCHUMER. Thank you very much. Dr. Brown.

[The prepared statement of Mr. Brown follows:]



THE HONORABLE LEE P. BROWN

DIRECTOR

OFFICE Or^ NATIONAL DRUG CONTROL POLICY

EXECUTIVE OFFICE OF THE PRESIDENT



TESTIMONY



BEFORE THE
HOUSE COMMITTEE ON THE JUDICIIUIY
SUBCOMMITTEE ON CRIME AND CRIMINAL JUSTICE



September 29, 1994



10



It is a privilege to testify before you today Mr. Chairman
and to have the opportunity to discuss the increasing concern
that we might be on the verge of a heroin epidemic. Various news
accounts over the past year have been tracking what appears to be
an increase in the availability of heroin on our streets, as a
result of lower prices, greater purity, and bumper crops coming
out of both Southeast and Southwest Asia, as well as South
America. Only two weeks ago, as I am sure you know. Parade
Magazine began a cover story stating that "a hideous scourge is
reappearing all across America," referring, of course, to heroin.

The Office of National Drug Control Policy ( ONDCP ) has been
long concerned about the seeming re-emergence of heroin in the
United States. Faced with reports of increased access to heroin,
we have undertaken a new study, the Pulse Check, which is an
ongoing series of interviews with street ethnographers, police,
and treatment providers to determine the nature and extent of
heroin use because traditional survey data does not document
heroin use accurately. I have visited many treatment sites to
get a better feel for the extent of the problem.

We are finalizing a heroin strategy at the direction of the
President to address the problems of trafficking, production, and
use. To facilitate that process, I have traveled this past year
to Southeast Asia and to Africa to enable me to obtain a first
hand understanding of the scope of the problem we face.

Are We On the Verge of a Heroin Epidenlc? Taking everything
into account, it is my belief that the United States is NOT in
the midst of another heroin epidemic. However, we ARE seeing
increased heroin consumption, but the bulk of this appears to bo
the result of increased levels of use among existing drug users.

If we were on the verge of an epidemic, we would see a
growing number of young people among the new users, and more
recent dates of first use, as they entered treatment. The



11



widespread heroin smoking - nd snorting in lieu of injection —

among those showing up at jails and treatment centers would be a
very ominous sign and indicate greatly increased use.

Let me explain why new users are of particular concern for
us. Heroin use spreads primarily among friends and peers. New
users, typically within their first year of use, are the most
likely to introduce others; long-time users are the least likely.
The implication is that new heroin use is susceptible to periods
of explosive growth. If the number of new users rises, they in
turn initiate more new users.

Again, there is no evidence that the United States Is
witnessing an epidemic of heroin use that is even remotely like
what we saw during the late 1960 's and early 1970 's. If the
increase in supply and purity is having an effect, it is probabiy
only effecting the way heroin is used by mature heroin addicts.
And new initiates are likely being drawn from the pool of career
drug users who are just now beginning to sample heroin.



IF THERE IS NOT AN EPIDEMIC, THEN WHAT DO TEE STATISTICS AND
SURVEYS INDICATE?

There is growing evidence from a range of sources that
domestic heroin consumption is on the rise.

Heroin consumption appears to be growing especially among
existing heroin users - that is, the amount consumed per user is
going up. There is an expected progression of increased
tolerance among heroin users. But wa see heroin use also on the
rise among drug users whose prime drug of abuse is not heroin.
The link is especially strong for longtcrm users of cocaine,
particularly in its "crack" form. Further, evidence suggests
that heroin snorting has become more commonplace in those areas

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of the country where high purity heroin is readily available,
primarily in the northeastern United States.

Reportedly, crack users often move into combined use of
heroin because it softens the impact of the "crash" that always
follows a crack "high." Many of the new initiates to heroin use
are drawn from the pool of career drug users who are sampling
heroin for the first time.

We estimate that there are about 600,000 chronic, hardcore
drug users who report heroin as their principal drug of abuse -
or about 22 percent of the estimated 2.7 million hardcore drug
users in the United States. (Hardcore use is defined as those
who use heroin at least on a weekly basis. ) We believe that ah
increasing number of the 2.1 million hardcore cocaine users are
increasing their use of heroin to complement their cocaine use.

According to the National Household Survey on Drug Abuse
(NHSDA), the number of heroin users measured in that survey of
households has remained virtually unchanged since 1988:
according to the NHSDA, at least 0.3 percent of household members
report heroin use in the past year. While this survey is known
to undercount heroin users, especially hardcore heroin users, it
is still a useful source of information for detecting increases
in the number of new initiates to heroin use.

The typical heroin user today consumes much more than a
decade ago. This is not surprising given the low price and
higher purity reported today. Until recently, heroin was almost
exclusively injected, either intramuscularly (skin-popping) or
intravenously. Injection is the most practical and efficient way
to administer low purity heroin. The availability of higher
purity heroin has meant that users can now choose to snort or
smoke instead of injecting it. As a result, heroin is more
socially acceptable among a whole new group of people - tne fear

3



13



of injection and injection-borne diseases such as HIV/AIDS and
hepa-itis is reduced, and some of the stigma is removed.

Data on heroin- related emergency room visits show that the
problems associated with longterm heroin use are on the rise.
Data from the Drug Abuse Warning Network (DAWN), which reports on
drug-related activity in our hospitals, shows a sharp increase in
heroin emergency room incidents. The annual number of heroin-
related emergency room visits rose from 38,100 in 1988 to 48,000
in 1992 - a 26 percent rise. The growth in heroin-related
mentions was most significant between 1991 and 1992, when it grew
by 34 percent.

The main reasons given for these heroin-related visits were
the effects of chronic, long-term use and overdose. Heroin-
related mention is highest among those between the ages of 26 and
34.

Heroin use is rapidly becoming a greater burden on the
treatment system. According to data compiled by the Substance
Abuse and Mental Health Administration (SAMHSA) and the National
Institute on Drug Abuse (NIDA), since the mid-1980's there has
been a substantial increase in reported admissions to treatment
programs where heroin is the primary drug of abuse. According to
data compiled by SAMHSA and NIDA, admissions to treatment for
heroin use grew at an average annual rate of 10 percent, from
87,043 admissions in 1985 to 142,372 admissions in 1991. While
this growth is well below that reported for cocaine treatment ( 37
percent per year), it is indicative of the substantial growth in
heroin use and the problems related to that use.

The Drug Use Forecasting ( DUF ) program administered by the
National Institute of Justice shows no clear national pattern in
heroin use by arrestees. In some cities, heroin use is high and
rising. Manhattan reports that 24 percent of arrestees test

4



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positive for heroin, a level that has remained fairly stable
since data were f rst collected. In most other cities, the
percentage of arrestees testing positive tends to be below ten
percent and fairly stable.

Our ovm Pulse Check also indicates that heroin use
nationwide, while still low, is increasing. Use is highest in
the Northeast and Midwest, but still low in the South and West.
Zhe Pulse Check also indicates that, while the majority of heroin
usars are in their thirties or older and are injecting the drug,
there are more younger users (ages 21-30) beginning to inhale
heroin. But we only see this in areas where high purity heroin
is readily available.

The Pulse Check also found that heroin sellers are
responding to this trend by promoting their product as "high
P'.:rity" and by offering heroin for inhalers and heroin for
•njectors packaged and "cut" in different ways.

We find that drug sellers, in general, and heroin sellers,
in particular, are becoming more creative in the ways they are
packaging and marketing drugs to attract and maintain customers.
This includes heroin sellers processing heroin for smoking and
offering multiple drugs to their customers; e.g., heroin and
crack .

These innovations are clearly attempts by sellers to
maintain a share of the market. Whether these are signs of an
evolution of drug dealing as a business, or early indicators of
either a surplus of drugs or a decline in demand is unclear, but
we will continue to monitor the trends.

We have tracked heroin use and its consequences carefully
ard continuously. And the President's policy and budget
recommendations are a direct and targeted response to our

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assessment.

In the Interim National Drug Control Strategy in September
1993, and again in the National Drug Control Strategy released
last February, we stated clearly that, despite the significant
decline in non-addicted drug use from 1985 to the present, we
still have two very serious problems.

The first is the persistence of chronic, or hard-core, drug
use. The second is a detectable change in our young people's
attitudes and behavior with respect to illegal drugs.

Hardcore users drive demand for drugs. They use over two-
thirds of the cocaine although they number less than a quarter of
the user population. Information on the 600,000 heroin users
shows similar behavior. Heroin addicts are increasing their use.

Reduction in demand for drugs requires reduction in the
hardcore user population. And reduction in this population will
be accomplished most cost-effectively through drug treatment.
For this reason, drug treatment for hardcore users was the
central initiative in the National Drug Control Strategy.

Expanding treatment for heavy and addicted users requires:
(l)adding treatment capacity both in our communities and in our
criminal justice system; and (2)support for offender management
program;^, for vocational and educational services, and for the
training of treatment staff. It means significant expenditures
but the costs are small only in relation to inaction.

Since the Strategy was released in February, two major,
independent studies have echoed the Administration's position.
In June, the RAND Corporation reported drug treatment to be a
cost-effective means of drug control intervention. And last
month, a comprehensive study of drug treatment in California:



16



"Evaluating Recovery Services: The California Drug and Alcohol
Treatment Assessment" concluded that for every dollar invested in
drug treatment in 1992, taxpayers received S7 in savings over
1992 and 1993.

The Strategy supports both pharmacological and non-
pharmacological treatment for heroin addiction. Numerous studies
of opiate addicts found an average reduction in daily narcotics
use of 85 percent during treatment and a 40 percent decrease in
property crime. Untreated opiate addicts die at a rate between 7
and 8 times higher than similar patients in methadone programs.

The research consistently shows that drug dependent people
who participate in drug treatment, when compared to those who do
not, decrease their drug use, decrease their criminal activity,
increase their employment, improve their social and interpersonal
skills, and physical health.

I believe there is some agreement between the Congress and
f-e Administration on this issue. For example, the Congress has
included injecting drug users among the priority populations for
drug treatment under the substance abuse block grant program.
However, as you know, the additional S67 million appropriated by
the House-Senate Conference for the Substance Abuse Prevention
and Treatment Block Grant for SAMHSA did not support the
Administration's request to fund an additional 74,000 chronic
hardcore users.

We know that drug treatment Is an effective means to foster
community stability and stem the criminal and infectious disease
consequences of heavy drug use; yet drug treatment remains
underfunded.

Doth treatment and prevention efforts are made even more
difficult when addicted celebrities are glamorized.



17



Unfortunately, the images of famous people have been enlarged in
de-\th as a result of their drug related lifestyles.

Serious prevention efforts involve a change in attitude to
convince people - especially our young people — that heroin is
a deadly, highly addictive drug that destroys lives.

As you know, the cocaine epidemic that reached its peak in
the mid-1980 's was turned around by an aggressive national
campaign that succeeded in "denormalizing" cocaine use,
persuading people that cocaine was not the fashionable, safe,
recreational drug that had been portrayed in the popular media.
You may recall that famous Time magazine cover, in which a
cocktail glass filled with cocaine was represented as the
"martini of the 80 's."

We have been moving aggressively to step up our efforts to
educate young people, and all Americans, about the dangers of
using heroin and other illicit drugs. The President's budget for
fiscal year 1995 requests an additional S448 million for drug
education and prevention programs, a 28 percent increase. This
includes S191 million for the Safe and Drug Free Schools and
Communities Start Program. We are targeting our prevention
programs to focus on those who are especially vulnerable to
heroin use, such as the children of intravenous drug users,
pregnant addicts, and inner city youth.

In large part as a result of your efforts, the crime bill
recently signed into law provides several important new
prevention programs which will be key to changing attitudes
towards drugs. The Crime Prevention Block Grants, the Gang
Resistance Education and Training Program (GREAT), the Model
Intensive Grant Program, the Local Partnership Act, and the Ounc«
of Prevention Council, can be used in part for prevention
programs. COMPAC (Community Partnerships Against Crime), the

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Administration's proposal to strengthen drug prevention programs
in public and assisted housing communities, can provide a model
for successful partnership programs.

THE WORLDWIDE THREAT

The worldwide heroin threat requires a significantly
different approach than that prescribed for cocaine. The heroin
industry is much more decentralized, diversified, and difficult
to collect intelligence on and conduct law enforcement operations
against. Like the Latin American cocaine trade, heroin
trafficking has become a worldwide industry run by transnational
criminal organizations. Analysis of international trafficking
trends suggests that the proceeds from retail heroin sales range
from S4-S10 billion in the United States and from S5-S25 billion
in Europe - the two primary heroin markets. There are other
critical developments:

• Worldwide opium production has quadrupled in the last
decade.

• Poppy growing areas are expanding in Afghanistan and
the new republics of the former Soviet Union.

Heroin addict populations, particularly in Asia, are
increasing.

• South American heroin from Colombia is now being
shipped by the cocaine cartels to the United States.

Criminal groups, attracted by the huge profits of the trade,
are moving large quantities of heroin to the United States and
Western markets. Heroin may pose a greater long-term threat to
the international community than cocaine because there is more
than sufficient capital from illicit heroin sales to increase the
risk of corruption throughout the world. Consequently, the need

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to focus on heroin trafficking involves serious concerns about
international political stability.

In many countries opium and heroin are the drugs of choice
among users of illicit drugs, and production of each is up
dramatically. Today at least 11 countries produce a total of
3,700 tons of illicit opium for the international drug markets,
more than double the production a decade ago. Heroin refining
occurs in nearly all producing countries, as well as in some
transit and consumer countries. While Southeast Asia remains the
largest producer and supplier to the U.S, heroin market
requirements could easily be met by Western Hemisphere sources.

Moreover, the demise of the Soviet empire has significantly
changed the international political and geographical landscape,
and the drug industry is responding to an array of new business
and criminal opportunities. Traffickers now use new smuggling
routes that traverse the poorly guarded borders of the Caucasus,
Central Asia, and Eastern Europe, where local law enforcement is
poorly staffed and ill equipped to oppose them. In some cases
the "new" routes are in fact old smuggling highways that until
recently were blocked artificially by the Soviet Union or by
regional conflicts, as in the Balkans.

We are in the process of developing a proactive
international heroin strategy that will seek to mobilize and
unify threatened nations around the globe against the
traffickers. I believe that we can succeed, if we act
aggressively and have the patience to sustain our effort over the
long term.

The Heroin Strategy

As you know the President has directed me to develop a
separate international drug control strategy for attacking heroin
trafficking which is near completion. Given the

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decentralizarion, breadth, and diversity of the heroin industry,
there is no practical alternative to a multidimensional and
global approach to the heroin problem that involves diplomatic,
law enforcement, and intelligence counterdrug initiatives in
cooperation with our allies in Asia, Africa, Latin America, the
Middle East, and Europe. Our international heroin strategy will
focus on:

reducing the supply of heroin entering the United
States;

treating heroin trafficking as a serious national
security threat;

dismantling the illicit heroin trafficking
organizations by prosecuting their leaders and seizing
their profits and assets; and

• expanding and intensifying contacts with foreign

leaders in order to mobilize greater international
cooperation and support against the threat of heroin.

A source-country approach of the kind we have employed
against cocaine trafficking is not feasible, since poppies are
too easily and profitably grown throughout the world. No single
country or group of countries has the resources, knowledge, or
worldwide reach to address this complex challenge. The
international community must unite to deny the illicit drug
industry tne ability to expand its criminal empires and undermine
national security interests. Such a strategy requires leadership
and long-term political commitment, as well as close coordination
between our international initiatives and our domestic
enforcement efforts — rather than with dollars alone.

There are several important components to our strategy:

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Heightening international attention. We will seek to
boost international awareness of the heroin threat and
strengthen the political will to combat it. We have to
convince nations that effective drug control is n
their own interest. Accordingly, we have to raise the
priority of drug control in our bilateral relations
with all opium source, transit and consumer countries,
so they can carry a greater share of the counter-drug
burden.

Emphasizing a multilateral and regional approach. We

will engage the world community to find an
international consensus for chemical and financial
legislation. We will work through international donor
organizations to provide seed money for development
programs. We will develop antidrug information sharing
programs with our allies in Asia, Africa, Latin
America, the Middle East, and Europe.

Supporting indigenous programs. The United States has
a vital interest in the ability of other countries to
use their legal processes to thwart heroin trafficking.
We will help these countries improve their law
enforcement practices and techniques and improve
coordination among the various law enforcement
programs .

Attacking the trafficking infrastructure. We have to
focus the worldwide effort on trafficker leadership,
money laundering systems, chemical sources, and
communication/transportation networks. This effort
also involves maintaining a DEA and intelligence
community presence abroad to counter the global
movement of drugs and drug monies and to foster greater