In my view, the essential element in ending a drug's use is that a consensus exists that the drug is bad in any amount. That is why cocaine was essentially wiped out.

In 1914, when the first prohibition amendment started through Congress, James R. Mann, more famous for the Mann Act, shepherded the Harris or Anti-Narcotic Act through Congress. No problem, Congress was opposed to narcotics.

The next week he led the fight against the prohibition amendment in the House of Representatives. Rep. Mann, like many others had a very distinct view between the two substances, namely because alcohol had become a major element in so many lives, culturally.

Talking to the current situation, most of the drugs-heroin, cocaine-have been found by the American people to be without merit in recreational use. We are in the process of making these decisions about marijuana at the present time.

I don't see that prohibition shows that we should abandon attempts to control these substances. I would say that prohibition shows that you can have a law about a substance that even is considered quite okay by many citizens and you can still reduce enormously the consumption.

The death rate from liver cirrhosis in the 1920s was cut in half by prohibition. It would have gone up if we did not have prohibition. You have to look at what it is you are dealing with and what is the response.

I would say prohibition does not offer any support for the idea of legalizing cocaine.

Mr. RANGEL. The Chair would like to recognize Mr. Guarini, one of the senior Members of our committee.

Mr. GUARINI. Culturally, our society is changing. I think we all agree that we have single-parent families, are taking the grandparents out of the family, and are replacing them with day care centers.

You say education is important. I agree with you, and we should do more for treatment rehabilitation. I also agree with you. Then the problem will eventually ameliorate.

Have you put in to your consideration the changes that are taking place, which are enormous in our society today, to base your conclusion on the fact that we don't need more penalties, we don't need more law enforcement, we don't have to go after users? What is your general opinion concerning these changes that are taking place that will effect the long-range drug problem in our country? Dr. MUSTO. I hope I have made it clear I am not opposed to law enforcement in drug control. I think it is very important. To assume you will just wait around for people to stop using drugs is not a reasonable thing and it is something I don't think the American people would stand for either.

I see, from looking over the changes of attitude in this country, that a very profound change has taken place with regard to these drugs. We have moved from seeing them okay if you don't misuse them to not okay in any amount. I think a lot of antidrug efforts are going to appear to work better than they did 15 or 25 years ago: law enforcement and education will seem more effective.

When we were on the upturn of the drug problem in the early 1970's, education seemed to be of no effect at all. I think you will now find people more receptive to antidrug education for they have already learned a lot from looking around them.

I am not saying those things are not important. I also am not saying we should just stand idly by and see if it takes 10 or 20 years for this to go away. I am saying that one has to be careful that the antagonisms that grow up around drugs may become so enormous that they sanction any action labelled antidrug.

I will give an example. Cocaine had come to be seen as the most feared drug in America in the 1920's, but it was also seen by a majority of the population to be almost a black drug. It was not. It was given as a reason for black hostility in the South, at the time of lynchings, of voter disenfranchisement. Not only did cocaine become a source of problems, but it became an explanation for resistance to actions that should have happened.

So in this atmosphere, you have an almost magnetic attraction between otherwise distinct social problems. Drugs can become an explanation for just about anything.

I am not dealing with the specific issues currently before the Senate. I am simply saying that one has to be very careful that in the antagonisms to drugs, we don't indulge in overkill and also not become unduly disappointed when the drug problem does not go away in 2 or 3 years, because that is most unlikely.

Mr. GUARINI. As a historian and someone who has studied our culture as it relates to the medical field, knowing the behavior of people in our society, which I imagine is very complex because we have such a mosaic society, would you say that we would be advised to go after the user at all? Should there be penalties against the user, such as marking his passport, taking his driver's license away, or taking away certain benefits he would get as a citizen from, say, school, loans and such? Would that help?

Dr. MUSTO. My feeling is there should be some user responsibility or some user effect; if you have decided this is a very dangerous substance, you want to discourage use, but I am not able to comment on those specific recommendations contained in the bill. I have not seen the bill, and I have not considered what all the actions might be.

Mr. GUARINI. We could go after that part of the demand equation?

Dr. MUSTO. Yes. I think that it is effective and has been shown in other areas, such as in our battle against racial discrimination, that it is important to have laws appropriately applied.

Mr. GUARINI. And disincentives?

Dr. MUSTO. And disincentives. There is nothing unusual about that. I am concerned about the level to which it might go. For example, in the decline phase, as fewer and fewer people use the drugs in the 1930s, 1940s, and 1950s, the penalties got higher until in 1955 we had the death penalty. Senator Price Daniels put that ino his drug penalty bill. I remember interviewing Harry Anslinger, who was our Narcotics Commissioner for 32 years. I asked, "how did the death penalty get into Senator Daniels' bill?" Anslinger replied, he wanted to make this bill different from any other bill on this issue.

Congressman Boggs had sponsored an Act in 1951 that got a lot of attention by imposing mandatory minimum sentences. Senator Daniels went one better and put in the death penalty for anyone over 18 who sold heroin to anyone under 18. To my knowledge, no one was ever executed, but it did give that extra fillip to the bill it might have lacked otherwise.

Well, extreme punishments for possession is not practicable once you start having widespread use of drugs in society, and I think we have to be careful not, as drugs go down, to create draconian penalties which if enforced would completely fill the jails to overflowing, or if not enforced would lead the public to be extremely frustrated that the bill had been enacted, but ignored. I think you have to work between these two areas.

But we have had the death penalty before. As I said, no one died from it, but it was added more for public relations than as a law enforcement necessity.

Mr. GUARINI. We had it for kidnapping, and it seemed to be effective after the Lindberg trial.

Dr. MUSTO. I am just referring to drugs.

Mr. RANGEL. We have been joined by Mr. Oxley, a member of this committee, who has made an outstanding contribution on the House Floor, as well as the Select Narcotics Committee. He is a former FBI agent. We welcome you. You may inquire.

Mr. OXLEY. Thank you, Mr. Chairman.

If we are to believe the testimony from some yesterday, particularly Mayor Schmoke of Baltimore, we have lost the war on drugs. If we were to accept that as a fact, does the Baltimore Mayor's prescription of legalization win us the war on drugs; and if so, how does it do it?

Dr. MUSTO. As I understand Mayor Schmoke's proposal, he would have drugs carefully controlled, by doctors or other responsible people who would make these decisions. This proposal has no relationship to the actual drug user. I have been struck by the extreme difficulty of reaching out to people who have drug problems, especially in the United States. These are people who will not come near any organization, much less a doctor who is going to write a prescription for them. It is extremely difficult to reach them. This proposal would only deal with a small number of people.

If you are going to legalize drugs, you are going to have to make them as available as if they were commodities in supermarkets because any hurdle you put in is going to create a black market instantly. There are people who will not go to a doctor to get a prescription, who will not get involved with some sort of bureaucratic organization. I see the idea of a clinic system as unrelated to the people having the serious drug problems in the inner city. I don't see how it would work.

Mr. OXLEY. I am with you. I had some real problem following that testimony yesterday.

There has been a lot of discussion also about the difference between alcohol and drugs, and those who say alcohol is indeed a drug may very well be correct, but you pointed out that there is a certain degree of public acceptance of alcohol vis-a-vis hard drugs.

It seems to me that one can use alcohol in moderation with little or no damage to one's body or to others. It seems to me quite a dif

ferent story as it relates to hard drugs. Do you agree with that premise?

Dr. MUSTO. Yes, in general. That depends on what you define as a hard drug. I do believe alcohol is a drug. There is no way around it, it is a drug. But it is one in which we have come in many of our cultures in America to accept as an ordinary everyday thing. I see increasing signs of turning against alcohol. If I were to make a guess, I would say alcohol in the next decade or so is going to go under a lot of scrutiny in the United States. It has already begun with the labeling campaign and awareness of the fetal alcohol syndrome.

But my point is not that it cannot cause some difficulties. It is that it is impractical to prohibit something which has achieved a cultural status in our country, and we have tried it twice, not just once. We did it earlier in the 19th century. I think the evidence on this is pretty straightforward.

Mr. OXLEY. If I could follow that up a bit, it seems to me that in the relation of alcohol versus, say, cocaine or heroin, the evidence is rather clear one can use alcohol in moderation but at least to me there is some question as to whether one can use cocaine, a crack derivative, or heroin in moderation. It seems to me further that it begs the question when you are talking about the effect that those drugs have.

Dr. MUSTO. Yes. Cocaine, in particular. I don't see any future for a cocaine maintenance program. That seems a very strange thing, because it only makes you more twisted in your thinking and more liable to difficulty the more you take. The idea you would simply maintain someone on it seems to me to be very peculiar.

There was an attempt when we were trying maintenance around World War I to maintain people on cocaine in several places, and they all dropped it. It was simply unworkable, although they continued with morphine maintenance in these areas.

Mr. OXLEY. What about tobacco, does that present a more difficult argument for you? There was some discussion yesterday about tobacco versus drugs, and I wonder what your opinion is on that. Dr. MUSTO. What I am trying to do is to try to discuss the dynamics of why we control things and what our experience has been; and with regard to tobacco, I believe in American society tobacco has undergone that crucial shift being seen as something which is really essentially harmless, sort of like a beverage, to something that is seen as extremely dangerous in any amount. I would say tobacco has made this transition, and I anticipate further restrictions on tobacco in the future.

Mr. OXLEY. One last question: Have you seen any evidence that the highly publicized deaths of athletes like Len Bias and entertainers like John Belushi have had any effect on shocking people into avoiding drugs?

Dr. MUSTO. That is a very interesting question, because I look upon some event like that like almost an experiment, as if you are taking the temperature of the public. If you go back to the early 1970s, when some of the rock stars died of heroin or whatever, it didn't seem to have any remarkable effect. It was thought they got bad stuff, they used too much, or had some physiological idiosyncrasy.

But as we have changed our attitudes toward drugs and these people have died, such as Len Bias more recently, it has been interpreted as proof of what cocaine will normally do to you when you take it as directed, so to say. Our reaction to Bias and the football player who died and John Belushi has been to confirm this new attitude toward cocaine, that it is bad in itself.

If you go back and look at famous deaths in 1969 or 1970, you will see they were explained away as being an accident. And so I think that what these deaths do is tell us where the public is with regard to their attitude towards cocaine. The public has become extraordinarily negative towards it. And, as I say, that is the groundwork for reduction in demand.

Mr. OXLEY. Thank you. Thank you, Mr. Chairman.

Mr. RANGEL. I would like to recognize Mr. Garcia of New York, a strong supporter of the Select Narcotics Committee.

Mr. GARCIA. I will be very brief.

I have a statement I would like to enter into the record as part of this hearing.

Mr. RANGEL. Without objection.

[The prepared statement of Mr. Garcia appears on p. 126.] Mr. GARCIA. Thank you.

I would just like to say to you, Doctor, back in 1967, 1968 as a young State Senator, I received a grant, and I went over to England to meet with some of the people who were there, and I remember sitting in a clinic, sitting and watching people shoot up, and I was amazed by it because prior to that, the only time I ever saw people shoot up were on roof-tops in areas like mine, and one of the things that came out of it for me was, as I sat and talked to these young people, each one of them without family said to me, "I want to get off, I want to get off."

And it seemed to me the English program, as it was then, it wasn't so much against the doctors as the chemists, the chemists were finding themselves in all sorts of trouble with prescriptions and giving out these prescriptions and being brought in by the home office and the law enforcement agencies over there.

So here we were treating the people who were "under the legalized system", and yet they themselves wanted no part of it. So it just seems to me that the advocates who have been pushing for the question of legalization should understand that as far as I am concerned from that little experience that I had back in 1968, that it didn't serve anybody's purpose, including the addicts. They were the first ones to say they wanted no part of it.

So I think my colleague, Frank Guarini from New Jersey, said this is very interesting testimony, and I would agree with him on that. I guess it is more of a statement, taking advantage of this moment that I have with you, Doctor.

The second part of it is that there is no question-I represent the South Bronx-there is no question that the problem is a major problem today, the profit motive is high, it is there, it is real, but it just seems to me whether we have the methadone clinics, which there are quite a few in my district, or we have these young people selling crack on the corner, the real problem is, as far as I am concerned, is not really to legalize. The bottom line is to try our abso