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Drug & Alcohol Headline Week in Review from MOMSTELL.COM

OCTOBER 10, 2004 Edition



        Again we have a lot of very important news this week.  I received this e-mail from Congressman Souders office and I want to pass it on to you. Please check this site out.  It contains  a lot of very informative articles.  Have a great and productive week!
Sharon L. Smith
Box 450
Mechanicsburg, Pa. 17055
Hello friends! 
My name is Malia Holst and I work in Congressman Mark Souder's Subcommittee on Criminal Justice, Drug Policy and Human Resources.  We have recently added a few documents to our web site, called "Backgrounders,"  which seek to provide information to the public on crucial drug issues.  Among these documents are "Backgrounders" on "medical" marijuana, methamphetamine, and the Andean Counterdrug Initiative.  I have provided the URL (below) for the "News" section on our web site, which will be the home of many similar documents in the future.  Please pass this URL along to others who may be interested.  In addition, please provide feedback and ideas for this section of our web site.

Malia Holst
Subcommittee on Criminal Justice,
 Drug Policy and Human Resources
Committee on Government Reform


Police say marijuana a factor in crash that killed Liberty student.

Sixteen-year-old Christina Martucci was driving with a ''significant amount'' of marijuana in her blood when she failed to yield at a stop sign, leading to a collision with a school bus that killed a Liberty High School classmate on the first day of school, Bethlehem police say.
The junior, accompanied by her attorney and family, turned herself in to police Friday morning and was fingerprinted and charged with vehicular homicide in the death of one of her three passengers, James D. Smith, 16, of 808 Broadway, Bethlehem.

Martucci, dressed in a bright red T-shirt, a white and red striped belt and dark jeans, covered her face with her hands as she was led out of the police station in handcuffs and into a waiting police cruiser.
''She is in an unfortunate position, but her actions led to the events that put her in that position,'' Lt. Dave Kravatz said. ''This was an accident that was completely preventable.''  Martucci's attorney, Christopher Spadoni of Bethlehem, and her parents declined to comment as they came out of the police station. Police ended their six-week investigation this week, concluding that marijuana use and the stop-sign violation were the key factors that led to the Aug. 31 crash at Lincoln Street and Easton Avenue.

Two other 16-year-old Liberty students — Kayla Fenstermacher of 825 Wood St., Bethlehem, and Yvette Rosa of 706 Wyandotte St., Bethlehem — were injured. Martucci, of 419 Dewberry Ave., Bethlehem, was taken to Northampton County Juvenile Detention Center in Easton, where she will be held at least until Tuesday, when she is scheduled to have a detention hearing.

Police said Martucci, who received her junior license less than a month before the accident, was driving her subcompact car north on Lincoln Street and tried to cross Easton Avenue but drove into the path of a Bethlehem Area School District bus occupied only by the driver.
Smith died at St. Luke's Hospital, Fountain Hill, and the three girls were also taken to the hospital.

Rosa was placed in a medically induced coma for three weeks for head injuries and has since been removed from a breathing machine. She is recovering at Good Shepherd Hospital in Allentown, where Fenstermacher goes twice a week to rehabilitate her fractured hip, cracked sternum and separated shoulder.  Bill Blake, a Northampton County assistant district attorney, said blood tests showed Martucci had more than two times the minimum level of marijuana metabolite in her blood needed to prosecute for driving under the influence. The minimum level is 5 nanograms of marijuana metabolite per milliliter of blood.

The police officer heading the investigation, Kenneth Jones, said Martucci had a ''significant amount'' of marijuana in her system.Police said they also found 1.2 grams of marijuana in a ''blunt'' cigarette — marijuana rolled in cigar paper — in Martucci's purse and 2.7 grams of marijuana and a smoking pipe in Smith's backpack.

Besides homicide by vehicle, Martucci is charged with three counts of reckless endangerment and one count each of involuntary manslaughter, driving under the influence of a controlled substance and possession of a small amount of marijuana. She is also charged with summary offenses of careless driving, reckless driving and failing to stop or yield at traffic signs.

Kravatz said the case has been tough for all involved. ''We've received so many calls concerning this case by parents,'' Kravatz said. ''We had to be sure this case was investigated thoroughly and handled properly.''

For more than a month, rumors have swirled throughout the Liberty campus as to what caused the crash and why Martucci was still allowed to drive to school, leading to arguments and at least one police incident report. ''It's really taken a toll on her,'' said Kimberly McFadden, a Liberty junior and friend of Martucci and the others. ''She's been in denial and was talking about going to seek counseling.  
''She probably feels like everyone is against her. She is seriously messed up.''
manuel.gamiz@mcall.com     610-861-3636  
Copyright © 2004, The Morning Call


Pro-marijuana advocates are united in their effort to pass an initiative to legalize the drug, but there is uncertainty on how to regulate it if the initiative succeeds.
"There's a large spectrum of opinion on that," said Mariann Wizard, a legalization advocate from Texas who traveled to Alaska for the campaign. "We really don't have as clear a blueprint as I wish we had."



Alaskans will decide next month whether to overturn a state law making marijuana possession illegal, but a court decision in 2003 may make the effort moot.
Legalization advocates are pumping hundreds of thousands in campaign dollars from outside Alaska to promote passage of Ballot Measure 2, while an opposition group in Anchorage operates on a shoestring budget of about $10,000.


A group working to decriminalize marijuana has received more than $500,000 from an Outside organization, according to reports filed with the Alaska Public Offices Commission.
Alaskans For Marijuana Regulation and Control has spent most of the $551,227 on radio and television ads, brochures, staff time and get-out-the-vote telephone pushes, according to the group's 30-day pre-election campaign disclosure report filed Monday.
All but $510 of the money came from the Washington, D.C.-based Marijuana Policy Project, which also is also funding pro-marijuana initiatives in other states.


MEDICAL MARIJUANA ADVOCATES LIKELY TO GET A BREAK UNDER KERRY - Democrat says he would stop pot club raids pushed by Bush

Sen. John Kerry hasn't tried to make medical marijuana an issue in his presidential campaign, but he has some differences with President Bush on the subject.
Kerry says he would end the raids that have been a feature of the Bush administration's crackdown on medical marijuana in California, where voters approved the use of the drug for medical purposes in 1996. The Massachusetts senator has also signed a letter urging the administration to stop blocking medical marijuana research at the University of Massachusetts.
Perhaps most importantly, Kerry said at a campaign forum last year that his "disposition is personally favorable'' to marijuana as medicine, but that he would await further scientific studies before taking a definitive stand. He also criticized mandatory minimum prison sentences for first offenders and called for more drug education and treatment.
That's not nearly as far as activists would like him to go. Kerry hasn't endorsed legalizing medical marijuana at the federal level or leaving the issue up to the states and hasn't backed legislation, currently stalled in Congress, that would allow patients and suppliers to use their state laws as a defense against federal charges.
But Kerry's position and tone suggest that he would take a different approach than Bush, who has escalated the federal war against state medical marijuana laws launched by his predecessor, Bill Clinton.

Four years ago, the state that had voted to send career criminals to prison for life with its tough three-strikes law shifted criminal justice policy in the opposite direction and opted to give drug users a break. Proposition 36, approved by 61% of California voters in 2000, allowed defendants convicted of drug use or possession to choose treatment in lieu of jail. It promised tax savings and signaled California's retreat from failed "drug war" policies that relied on punishment to keep addicts in line. But a new analysis of the law's effect points out challenges that never made their way into campaign ads.

Gerri Silverman, David Evans, Steven Steiner, Joyce Nalepka were there!
Gerri Silverman did a Herculean job of laying the groundwork on this bill.  Dave and Steven gave eloquent testimony.
We provided background information to Senator Rice, a former policeman, African American, eloquent speaker who we applauded held the floor--backed the supporters down and refused to give up--We won!

Opponents fight off panel vote leaving passage unlikely before McGreevey exits

Friday, October 15, 2004


Gov. James E. McGreevey's hope to sign a bill that would allow needle-exchange programs for drug users was dealt a serious setback yesterday as strident opposition to the plan stalled a vote in a key Senate committee.

Supporters concede the deadlock means the full Senate probably won't vote on the bill before McGreevey leaves office a month from today.

The governor pushed hard for lawmakers to pass the measure before he resigns, contending that allowing drug users to get clean syringes would slow the spread of AIDS and other blood-borne diseases. But the issue turned into one of the most divisive ones of the fall legislative session, with opponents arguing that providing access to syringes would condone illegal drug use and not stop addicts from sharing needles.

"The issue has clearly divided people," said Sen. Joseph Vitale (D-Middlesex), the bill's sponsor. "It has always been about getting enough votes to pass it. Sometimes it takes people awhile to get there. I want to give all my colleagues plenty of time to hear about the issue. It is not just ideological issues, there are questions about the legislation. It is not something you should rush."

The debate does not fall along party lines. Three Republicans helped pass the bill in the Democratic-dominated Assembly last week. Yesterday, the chief opposition to the measure was voiced by Sen. Ronald Rice of Essex County, who, like sponsor Vitale, is a Democrat.

Vitale, who chairs the Senate Health Committee, could not find the five votes needed for approval on his panel. He put off a vote until Nov. 8 at the earliest. The next voting session for the full Senate is scheduled for Dec. 6.

In a statement released through spokesman Micah Rasmussen, McGreevey said: "I am committed to working with the Legislature to secure passage."

Rasmussen, however, conceded the bill may not reach McGreevey before he resigns.

"The governor will continue to make the case that the legislation saves lives," he said. "He is going to identify opportunities like this until he leaves office. It has nothing to do with legacy, it has to do with governing."

Senate President Richard J. Codey (D-Essex), who will become acting governor after McGreevey quits, has not taken a position on the needle exchange bill, according to Kelly Heck, a spokeswoman.

"Senator Codey supported a sterile syringe bill when he was a member of the Senate Health committee some years ago ... but these are very different measures than the measure he supported," Heck said.

Heck said Codey would not intercede to push the bill forward in the Senate prior to McGreevey's expected resignation, saying its future would have to be decided in the health committee.

Dale Florio, a powerful lobbyist helping the Drug Policy Alliance push for passage of the legislation, said of Codey: "He will sign the bill, I know he will sign the bill."

In addition to Rice on the health committee, Sens. Robert W. Singer (R-Ocean), Thomas H. Kean Jr. (R-Union) and Diane B. Allen (R-Burlington) oppose the legislation, and Sen. Fred. H. Madden (D-Camden) is undecided. Vitale and Sens. Barbara Buono (D-Middlesex) and Ellen Karcher (D-Monmouth) support it.

With Rice, a former Newark police officer, vehemently opposed, sources said proponents will focus on Madden and Singer. Singer is a hospital executive and the measure is supported by the New Jersey Hospitals Association. However, he said yesterday he will not be swayed.

The controversial bill would allow towns or counties to authorize needle-exchange programs, which would be run in conjunction with local health care and drug treatment facilities, offering free information about HIV, substance abuse, and health care options along with sterile syringes. Drug users who wished to participate in a program would be given an identification card. A companion measure, which would allow pharmacies to sell 10 or fewer syringes without a prescription, also stalled.

Madden, a retired State Police lieutenant colonel, is concerned about how police would enforce drug laws amid needle-exchange programs. "I am wide open on this," he said.

Twenty people, including state Health Commissioner Clifton R. Lacy and Sen. Nia Gill (D-Essex), a co-sponsor of the bill, appeared at the hearing to call for approval of the needle exchange measure. Seven people showed up to oppose it.

The Health Committee yesterday did approve a third companion bill co-sponsored by Rice that would allot $6 million to purchase prescription drugs for needy AIDS victims, $1.3 million to help provide them health insurance and $2.7 million to help finance quick HIV testing.



Marsha Rosenbaum, a California drug policy reformer, said the pressures on children to try drugs require parents to give more than a "Just Say No" response, the Salt Lake Tribune reported Oct. 8.

Rosenbaum made her comments during a training session by the Harm Reduction Project in Utah. Based in Salt Lake City, the
"Safety First" project is aimed at preventing harm when people choose to take part in risky behaviors, such as drug use and prostitution.

"This is for parents that have tried abstinence," Rosenbaum said. "Parents just want a fallback strategy, a Plan B, just in case their children don't listen."

According to Rosenbaum, 54 percent of U.S. teenagers will experiment with drugs. She likened the "Safety First" strategy to the "safe sex" philosophy, in which children are given information about condoms and family planning. "It's like comprehensive sex education," she said. "For those kids that are not abstaining, what do you do? That's really the question."

Opponents to the approach said it could encourage more drug use or sexual activity. Law-enforcement officials support drug education programs such as DARE because they promote abstinence.

"We're big DARE supporters," said Ken Wallentine, a public affairs official for the Utah Peace Officers Association. "Our general philosophy is completely incompatible with the notion: 'We should surrender to drugs.' It's admitting we can't keep drugs out of our communities. We can. We are doing a good job."

But Luciano Colonna, director of the Harm Reduction Project, said parents want and need options. "This is a natural way to talk to your children," Colonna said. "You don't have to be involved with any harm reduction or progressive program."

The biggest challenge faced by the Harm Reduction Project is getting the "Safety First" program into public schools. Federal funding prohibits any drug-education program that promotes a message other than abstinence

 Click here: http://www.safety1st.org/pdf/safetyfirst.pdf



Voters in Alaska, Montana and Oregon will decide this November whether to ease drug laws pertaining to marijuana use, the Associated Press reported Oct. 10.

All three measures are offered as alternatives to federal drug policies that activists call harsh and ineffective.

Voters in Alaska will decide on decriminalizing marijuana completely. The measure would prohibit prosecution of anyone age 21 or older who consumes, grows, or distributes marijuana for private personal use. The measure would also treat marijuana like alcohol and tobacco, allowing authorities to tax it and ban it from use in public.

In Montana, voters will decide whether to legalize marijuana for medical reasons.

In Oregon, voters will determine whether the state's current medical-marijuana program should be expanded. Under the ballot initiative, state-regulated dispensaries would be created to supply marijuana, authorized growers would be able to sell marijuana to patients for a profit, and patients would be allowed to possess a pound of marijuana at a time, up from the current three-ounce limit.

U.S. drug czar John Walters has been making personal appearances in all three states to campaign against the measures. In Oregon in particular, Walters has waged an aggressive campaign.

"They use medical marijuana as a Trojan horse," Walters said. "People's suffering is being used for legalizing drug use beginning with marijuana and moving forward."

Sanctions-based demand reduction"

By Reid J. Epstein

Posted: Oct. 13, 2004

When Rhinelander police busted a man on suspicion of possessing cocaine he bought over the Internet, the usual course of action would have been to end the investigation after finding the source of the drugs.

But in a tactic authorities called one of the first of its kind in Wisconsin, federal investigators joined the case. They not only found what they believe was the drug source, but they adopted the accused online drug dealer's persona in order to catch his customers.

The new strategy, called sanctions-based demand reduction, was spearheaded by former Deputy Attorney General Larry D. Thompson, and it has gone into use here in the last six months, said J.B. Van Hollen, the U.S. attorney for the Western District of Wisconsin.

According to the charges against the man authorities identified as the online dealer, Thomaz W. Franzl, 27, of Chicago had a menu of 13 different substances that ranged from common prescription drugs, such as Ritalin and Percocet, to cocaine and methamphetamine.

The Rhinelander man who became an informant after he was arrested used his credit cards to purchase more than $6,000 in cocaine, OxyContin and Ketamine from Franzl between October 2003 and June 2004, according to an affidavit filed in federal court in Madison last month.

"Before, we probably would have just taken Mr. Franzl and closed down the site and not done anything further," Van Hollen said. "We wouldn't have gone down the ladder to figure out who some of his buyers are."

But in this case, the first involving Internet drug sales in the federal court's Western District - roughly the western two-thirds of the state - authorities from the federal Drug Enforcement Administration and the North Central Drug Enforcement Group, a conglomerate of several northern Wisconsin law enforcement agencies, pretended to fill Internet orders.

Prosecuting drug users has been primarily the responsibility of local and state law enforcement agencies, while federal authorities concentrated on kingpins and big-time dealers. But foreign countries that the government has been pressuring to curb their drug exports have responded that the United States is not limiting drug demand, Van Hollen said.

Because Franzl's alleged illegal operation used the Internet, federal prosecutors were able to increase the charges against his suspected customers. On Oct. 6 a federal grand jury in Madison indicted nine of Franzl's would-be customers not only on an attempted drug possession charge, which carries a sentence of up to one year, but also with one count of using the Internet to facilitate the unlawful distribution of a controlled substances. That charge has a maximum four-year sentence.

Mostly professionals

The accused customers were mostly white-collar professionals, according to Tim O'Shea, the federal prosecutor assigned to the case. Authorities said the seven men and two women included a 20-year-old female college student at Ursinus College in Pennsylvania who ordered Ritalin and Adderall; a 26-year-old public relations man in Chicago who ordered Ketamine; and a Glendale man who tried to have cocaine delivered to the house he shares with his parents.

The nine people charged have been ordered to appear in court in Madison but have not been arrested because they are not considered flight risks, O'Shea said.

They are:    Thomas Bronson, 46, of Somerville, Mass.; Steven Cornute, 21, of North Hills, Calif.; Ashley Hans, 20, of Collegeville, Pa.; Matthew Harper, 27, of Nashville, Tenn.; Jonathan Houlihan, 31, of Glendale; Brandon Jenkins, 21, of Scenery Hill, Pa.; Dane Kinchen, 20, of Richmond, Va.; Vince LaConte, 28, of Chicago; and Nicole Sears, 26, of West Sacramento, Calif.

Prosecuting Internet drug dealers' customers, Van Hollen said, sends a signal to others who order drugs on the Web or through the mail thinking it is safer than going into rough neighborhoods to purchase drugs.

No more hiding in offices

"We want to make sure that people out there know that even though they're sitting in their offices, there is a great risk of being found out," Van Hollen said. "We're trying to make sure that the Internet doesn't get used for inappropriate purposes."

But some experts on the drug war say prosecuting small-time drug users such as those ordering from Franzl won't help in the government's effort to wipe out drug sales.

"There's just no evidence at all that the government is having any significant impact on the drug market," said Tim Lynch, the director of the Cato Institute's Project on Criminal Justice. ". . . For this particular operation, it's not going to have much impact beyond those handful of customers. There's plenty more where they came from."

Lynch said that publicizing drug busts such as those of Franzl and the Internet customers might deter others from making similar purchases now, but it won't make a difference in the long run.

"If they can generate some media coverage of this operation, the idea behind it is they'll get people to think twice before purchasing things online," he said. "It might have some very short-term impact, but overall, I don't see it having any sort of an impact in the black market in narcotics."


Glasgow, Scotland
13 October 2004

A new report launched tomorrow Thursday 14 October is set to challenge the government's drug strategy.
The findings show that the majority of drug addicts contacting drug treatment services in Scotland are looking to achieve abstinence rather than to receive advice on harm reduction from treatment services.

The research, carried out by a team led by Professor Neil McKeganey at the Centre for Drug Misuse at the University of Glasgow, is to be published in the leading journal 'Drugs Education Prevention and Policy'.

The research involved interviewing 1007 drug addicts from 33 drug treatment agencies across Scotland starting drug abuse treatment in 2001. Sixty per cent of those interviewed identified abstinence as their sole reason for contacting drug treatment services. Seven per cent were looking for stabilised drug use and one per cent was looking for advice on safer drug use
'These figures show that most drug users are contacting treatment services to come off the drugs completely,' explains Professor Neil McKeganey.

'We have to hear these voices and ensure we have services in place that can help addicts overcome their addiction. Over the last ten years we have tended to prioritise harm reduction over abstinence and we need now to ensure that we have a balance between these two important aims.'

Bill Puddicombe, chief executive of Phoenix House, said:  'As the largest provider of abstinence based services, we have known for many years the positive outcome of this approach to treatment. This report supports our philosophy of recovery. We believe people can rebuild their lives, which is why we also help them with education and employment. Our results prove that this approach works. For example, 75 per cent of service users have been successfully detoxed at our Glasgow Adult Residential Service and 67 per cent of Phoenix House Access to Skills and Employment (PHASE) residents have gone on to access further education and paid employment'.

'What are drug users looking for when they contact drug services: abstinence or harm reduction?' will be launched by Professor Neil McKeganey at the Phoenix House Annual General Meeting on 14 October. The report will be published in October 2004 in 'Drugs: Education, Prevention & Policy Journal'.
The research was funded by the Robertson Trust and supported by the Scottish Executive.



Scott Burns, a top federal official in the war on drugs, visited Montana this week intending to discuss methamphetamine. Instead Burns found himself talking mostly about marijuana, as Montanans prepare to vote Nov. 2 on a ballot measure that would allow use of the illegal plant for medical purposes.

"I cannot tell anyone how to vote,'' Burns said - but his anti-marijuana message was clear. "This is a con by people who want people to legalize marijuana in this state,'' Burns said. "They always start with the medical marijuana issue.''

Burns, who is deputy director for state and local affairs in the Office of National Drug Control Policy, held a news conference Thursday in Billings at Rimrock Foundation, a private, nonprofit treatment center. He also met with local law enforcement and treatment center officials. Burns, formerly the county attorney of Iron County, Utah, made similar visits earlier this week to Helena and Missoula.

Initiative 148 would legalize the cultivation and possession of marijuana for medical use in Montana. Patients could use marijuana under medical supervision to relieve symptoms of cancer, glaucoma, HIV/AIDS and other conditions defined by the state. Proponents, Burns said, typically use the example of someone suffering from a disease and say that smoking marijuana offers relief. "It's not about that,'' Burns said. "It's about our children."

There are alternatives besides marijuana for sick people, he said. For example, Marinol, which is a pill containing THC, an active component of marijuana, is approved by the U.S. Food and Drug Administration and may be prescribed by doctors. The FDA, the American Medical Association and other medical groups have said that "smoking this weed is not a medicine,'' Burns said. Missoula resident Paul Befumo, a spokesperson for I-148, said in a telephone interview Thursday that he didn't think Burns had read the initiative.

"It's really really narrowly confined,'' Befumo said. The measure covers only people with the diseases specified and closes anything that could be viewed as a loophole, he said. Befumo also said Marinol has only one component of the many active ingredients in marijuana. "That's why when Marinol doesn't work, medical marijuana does,'' he said. Befumo said studies and research papers support the therapeutic potential of marijuana.

Backers of the measure point to the results of a California study that showed marijuana use by high school students declined after voters there approved the medial use of marijuana in 1996. Befumo stated earlier that the study did not indicate that the medical marijuana law was the cause of the reduced marijuana use but that "the law did not cause an increase in use as predicted by opponents.'' Burns said marijuana is considered by treatment experts to be a progressive drug, which leads to use of other illegal drugs. More youths under age 18 are in treatment for marijuana dependency than for any other drug, he said.

"The marijuana problem is a national problem,'' Burns said. Of the approximately 19.5 million people using illegal drugs, 77 percent use marijuana or marijuana and another drug, he said. Marijuana used to be a rite-of-passage drug for youths in their late teens. "It's now a middle school rite-of-passage drug'' with children aged 12 or 13 and even younger, he said.

"That's unacceptable. We don't need more marijuana available to our children,'' he said. Burns also said marijuana use still is illegal under federal law. There is "no safe harbor'' for marijuana users even if voters approve it for medical use, he said.

Information from the Office of National Drug Control Policy shows that marijuana use among eighth-, 10th- and 12th-graders has been declining in recent years. "We are pushing back,'' Burns said. He credited the declining use in part to parents getting involved. The least deserving of credit for declining use are those who support medical use of marijuana, Burns said.

And while marijuana is the most widely used illicit drug, methamphetamine, used by an estimated 1.5 million of the county's 19.5 million drug users, is a serious problem across the country, he said. Meth is highly addictive and can be manufactured in clandestine labs using commonly available ingredients, like pseudoephedrine, which is found in over-the-counter cold medication.  "This is a bad drug,'' Burns said.

On a national level, Burns said, the United States has clamped down on large shipments of pseudoephedrine from Canada and is helping local communities through federal funding of law enforcement programs like the High Intensity Drug Trafficking Area. Yellowstone County and four other Montana counties are in the Rocky Mountain HIDTA.

Law enforcement, prevention, education and treatment are needed to fight meth use, he said. Communities have to become involved and people have to intervene, he said. People are so polite in this society they are reluctant to intervene. "If you want to save someone's life, step in and intervene,'' he said.


By Bob Curley

Budget cuts and federal funding rules have put a number of states in jeopardy of being penalized millions of dollars from their all-important federal block grant allocations -- a double-whammy that state officials say could seriously impair their ability to provide addiction services.

Under the rules governing the $2-billion federal
Substance Abuse Prevention and Treatment Block Grant (SAPT), states are penalized if they fail the keep addiction spending levels within three percent of what they have spent, on average, during the previous two fiscal years. For each dollar the state falls short of the block grant's Maintenance of Effort (MOE) target, they risk losing a dollar of federal funding.

The Massachusetts state budget for FY2003, for example, fell $9.1 million short of what the state spent over the previous two years, meaning the state also could lose an additional $9.1 million in SAPT block-grant funds. Texas faces a possible $10-million penalty for FY2003 because of a budget recission ordered by the state legislature. California officials, meanwhile, worry that they will face MOE problems of their own if the state legislature does not support renewal of the $120 million in treatment spending authorized by voters under Proposition 36.

Designed to Protect

The MOE requirement was put into place to prevent states from substituting federal money for state funds spent on addiction services. Since all states receive a share of block grant funds, any money withheld from those who fail to meet their MOE requirements would be redistributed to the other states.

During the past two years, at least four states -- Massachusetts, Iowa, Texas, and South Carolina -- have formally requested waivers of the block-grant penalties from the Substance Abuse and Mental Health Services Administration (SAMHSA). Waivers can only be granted if the secretary of the Department of Health and Human Services determines that the state has suffered "extraordinary economic conditions," defined as a financial crisis in which state tax revenues decline significantly and either unemployment rises or employment drops.

In response to a Freedom of Information Act (FOIA) request submitted by Join Together seeking all waiver requests submitted by states within the past five years, SAMHSA provided documentation of waiver requests submitted by South Carolina in September 2002 seeking relief for the FY2002 block grant; by Massachusetts in December 2002, also seeking a waiver for FY02; and by Iowa in November 2003, seeking a waiver for FY2003.

Subsequently, Join Together learned that the state of Texas also had submitted a waiver request to SAMHSA for FY03, and that Massachusetts is seeking a second waiver, for FY03, as well. Other federal documents obtained by Join Together indicate that as many as eight states have had their budgets cut to the point where their federal block-grant dollars are in jeopardy.

Mark Weber, a spokesperson for SAMHSA, said the number of waiver applications received by the agency "waxes and wanes" from year to year, but said there "hasn't been a huge spike" in waiver requests since 2001. Weber described "a handful" of states that have had MOE difficulties, but SAMHSA would not provide Join Together with the exact number of states that the agency has been communicating with regarding budgetary and MOE issues.

"It certainly has been an issue in a number of states," said Paul Samuels, director of the Legal Action Center, which provides legal services and other support to groups like the State Associations of Addiction Services, whose members rely on the block grant as a primary funding source. "There have been a number of states that have contemplated or implemented cuts to addiction services, and in those cases MOE becomes a big issue."

Mixed Response

SAMHSA's response to the waiver requests has been mixed: in April 2003, waivers were granted to South Carolina for an MOE shortfall of $1.76 million and to Massachusetts for a $4.63 million shortfall, and Iowa was granted a waiver for a $380,000 shortfall in January, 2004.

In its FY02 request, Massachusetts successfully argued that the shortfall was due to "reduced revenue during this mild recession as well as aftereffects following the events of Sept. 11, 2001," and said that addiction services had not been singled out during wide-ranging budget cuts. Similar arguments were made by South Carolina and Iowa, and each state was able to demonstrate the employment and tax-revenue declines required to qualify for a waiver.

However, SAMHSA denied the $10-million waiver request submitted by Texas for FY03, and also has balked at a second waiver request from Massachusetts, which is seeking a $9.1-million block-grant waiver for FY03.

"We have every intention of enforcing the law as it is written, while working with states that have raised issues [with MOE] on an individual basis," SAMHSA spokesperson Mark Weber told Join Together. "Our number-one goal is getting services to people in need, but there's a law is in place that we need to adhere to."

Concept vs. Reality

In less-lean budgetary times, the MOE has often been a useful policy tool for advocates and state agency directors, who could argue against funding cuts by telling lawmakers that deep cuts would trigger the federal penalties. Indeed, in the midst of its current budget crisis, Massachusetts advocates were able to use the MOE as leverage to win a $11.9-million special supplemental budget appropriation for addiction services. However, while this funding should prevent Massachusetts from having MOE issues in FY04, it doesn't directly impact the state's FY03 waiver request.

"My experience over the past 20 years is that states can manage to put the money into addiction programs, especially with MOE hanging over their heads," said the Legal Action Center's Samuels. "Without MOE, you really would risk losing money in a lot of states."

John Carnevale, president of Carnevale & Associates and a former staffer with the federal Office of National Drug Control Policy, said the MOE concept works as long as state budgets remain level or increase. "It says to states, 'We're going to give you this money and make sure that you keep up your end,' which makes perfect sense," he said. "But when you have a downturn, all bets are off."

Critics say the MOE rules have proven inflexible in the face of sharp and broad cuts in state spending because they only cause more pain if states legitimately cannot come up with the money to meet the MOE requirement in a given year. Also, when spending cuts occur across the board, other constituencies and programs with their own MOE requirements are affected, making it a less-powerful tool for persuading lawmakers to back addiction services over others.

The block-grant MOE's two-year averaging rule also may have had the unintended effect of punishing states that, prior to the recent budget crises, had been increasing their spending for addiction services.

"It creates a disincentive for states to spend over their MOE target levels, because they get penalized for a short-term economic downturn," said Michael Botticelli, assistant commissioner for substance-abuse services in the Massachusetts Department of Public Health.

Ann Horn, deputy director of the department of administration in the California Department of Health Services, agreed. "Legislators and administrators have been unwilling to put extra money into substance abuse because of the MOE requirement, not only in California but in other states, as well," she said.

The 'MOE Bank'

Botticelli said members of the National Association of State Alcohol and Drug Abuse Directors (NASADAD) have proposed to address the problem by allowing states to establish an "MOE bank" that would give states credit for spending above their MOE targets. "Every dollar over the target amount would go into the savings account, so that when states can't maintain their spending they can 'draw upon' their account before they incur penalties," said Botticelli.

In appealing Massachusetts' FY03 waiver denial, Botticelli is asking SAMHSA to take into account the state's' strong record of funding addiction services during the past decade. Dave Wanser, deputy commissioner for behavioral and community health in the Texas Department of State Health Services, also is asking SAMHSA to reconsider its denial of his waiver request, arguing that the budget cuts have not significantly impacted the number of people getting addiction services, and requesting that a five-percent funding match required of Texas providers be included in the MOE calculation.

"I've always hated the MOE issue," said Janet Zwick, director of the Iowa Division of Health Promotion, Prevention, and Addictive Behaviors in the state Department of Public Health. "I think we have numerous states with budget cuts, and I can't believe we won't have many with MOE issues. I would like to see SAMHSA work with the states to make sure they don't lose money."

Botticelli and other state directors describe SAMHSA officials as generally willing to work with states to resolve the MOE crisis. "They don't want to see states lose money," said Botticelli.

Weber said SAMHSA is "open to all reasonable options," adding, "We're optimistic that we'll be able to work things out with the states. That's why we have this appeals process in place."