same weight that I see them talking about giving access to heroin and crack to addicts.

Mr. KAREL. My father was a research pharmacologist. That is a little of my background and I am familiar with the pharmacological issues. Alcohol is different.

If you have an opportunity to talk to Dr. Musto, you might ask him about this: one of the very legitimate uses of morphine in Kentucky by many responsible medical authorities was to substitute morphine for alcohol use in chronic alcoholics, an utterly astonishing concept today to most people. Why did they do it? Because morphine addiction, and this is what they were doing, addicting alcoholics to morphine, arrested result degenerative cirrhosis of the liver and did not result in the disruptive behaviors associated with alcoholism.

Mr. RANGEL. The addiction of people in my district to methadone is a heavier addiction than heroin. There is no limit as to what we should do. To try and stop it.

Mr. Guarini.

Mr. GUARINI. As I understand it, you made a hot dog, pastrami and apple analogy. Yet the Maryland Shock Trauma Center showed of the thousand-plus patients studied, about 35 percent were found to have used marijuana within four hours and 33.5 percent were found to have used alcohol, but 60 percent used both. So there were more using marijuana than alcohol.

Mr. MILLER. Which shows that prohibition is not working. If you lump them together and talk about marijuana, it is automatically slipped into heroin and cocaine, and marijuana is not addictive.

Mr. GUARINI. Something goes on in their minds psychologically and there is a rearrangement of behavior if they have marijuana. Mr. MILLER. I accept that, but if we can control the potency by bringing it out of the dark alleyways and into the light, if we can start being honest to people about what these substances do and have them listen because we are not lumping them together.

Education works in this country; coercion does not.

Mr. GUARINI. Studies show a correlation between people who begin on marijuana and go on to harder substances. If you are going to accept that fact.

Mr. MILLER. No. Surgeon General Koop's recent report showed the biggest gateway drug is that which is subsidized by the United States, tobacco.

Mr. GUARINI. Let's not talk about tobacco. That is a whole different bag. It is not a fair analogy. Let's talk about the pharmacology and the truth about marijuana. The fact is when you start with marijuana, people want more of a kick and they don't get it out of marijuana and they then go on to cocaine, crack, heroin, PCP and all these other things.

Am I correct?

Mr. MILLER. I don't think that is correct because you do not have a larger cocaine, crack, and heroin problem in Alaska than you do in New York where marijuana is available. The same is true for Oregon and other jurisdictions.

Mr. GUARINI. Is our research that we know of, all the differences in the use, treatment and addition of all the different kinds of drugs that are used, is there still perhaps, Dr. Boaz-Professor

Masi, perhaps you might be able to help us in this. Is there still a lot we don't know about all these drugs and the addiction attendant to those drugs? Are we still-is there a lot of research that has to be done before we can make definitive decisions?

Dr. MASI. First of all, I will qualify my statement by saying I am not a medical doctor, but I think I can answer this question. I think that NIDA has made tremendous strides in informing us about the drugs, and we do know a fair amount. We used to think, and I think you heard the testimony yesterday, about 10 to 15 years ago some of these drugs we thought were a lot less harmful than we realize today. I think we have a lot more information at our disposal and are finding out far more the dangerous effects of all of the drugs, including alcohol as well as tobacco, marijuana, cocaine, heroin.

Mr. GUARINI. But we are still in the position of having to get more facts to base sound decisions on?

Dr. MASI. Yes and no. I think we are learning a lot. I think more research is needed-I certainly would support more research in this particular area, but I also would support the need for training, education and treatment. I think there are the areas we really need the funding.

Mr. GUARINI. You don't support legalization of marijuana, do you?

Dr. MASI. No.

Mr. GUARINI. Why?

Dr. MASI. Why do I not?

Mr. GUARINI. Yes.

Dr. MASI. I think, for example, I see marijuana leading to other drugs and more addiction, which I am opposed to.

Mr. GUARINI. Let me ask one further question, if I can maintain just another line. The private sector you spoke of in the work place, do you feel the corporations of America are doing enough, could more be done? Is there a great loss of productivity which hurts our national economy which is not talked about very much, and that also affects our national defense because our military potential is reduced?

Dr. MASI. There is a tremendous cost to industry in the area I mentioned, productivity. A wide variety of ways are being effected in the workplace by drugs. We have to remember though that the primary drug of abuse in the work place clearly above all others is alcohol. However, I do think American industry is waking up. I think it has taken a while, but I think they are becoming more and more sensitive to the problems in the work place.

However, they don't know what to do. They are going into EAP programs, drug testing programs. As I work with companies, I am a social worker, working with companies day after day, and I say it is really tough for them, that is not their business. They are not in the business, for example, they are in another business producing another kind of product, and here they are suddenly thrust into drug prevention. So they are looking to the experts, asking what do we do? What can we do? But they know darn well they have a problem.

Mr. GUARINI. They should have a social conscience, not just an economic conscience, and they should be expected to pick up the cudgel and do more.

Dr. MASI. In no way do I want to give you the feeling their only concern is the bottom line. Industry knows the two go together. When you invest in people, you are saving money, and people are the more valuable resource. They know that, and they are investing and trying to find out what to do. But it is a major effort throughout the whole country, what do we really do? I think the most important thing about the work place that I hope came across is most drug abusers today are 40 years of age and under, they are not necessarily just the youth, just the kids, and I think it is a major mistake to emphasize all our Federal programs in only the direction of the young people, because actually the age group has literally moved up. So most drug abusers are literally working and are in the work place, and the work place is very aware of that. Mr. GUARINI. I think it is very fortunate they do understand the problem, and I would like to see Corporate America become even more deeply involved in solving some of our social problems.

Dr. MASI. I agree. There are still some out there not as aware. I am on the National Security Institute Board of Advisors for Defense Contractors, and I think the idea of our Secretary of Defense saying, for example, that all defense contractors should have EAP programs is very good, because you shouldn't have drug testing without the EAP programs. That is a major mistake, just to have the testing. We really need the employee assistance programs.

However, there are problems on the other side with the employee assistance programs who are not necessarily reaching the numbers of alcohol and drug people in the work place that we need to, and that is an area we need to work on for the work place.

Mr. GUARINI. Thank you.

Mr. Boaz. Could I address this?

The Congressman was asking about drug abuse in the work place and lost productivity. The most abused drug in the work place, which causes the most lost productivity, is alcohol. I would point out we don't conclude from that, therefore, we should criminalize alcohol.

Mr. RANGEL. You are opening up another door, and you might get some people to take a look at that too. I don't think you are making your argument by saying that because people are not critical of tobacco and alcohol that we should be more flexible on the question of marijuana.

Dr. MASI. Could I comment?

I don't want my statement to be read in fact because the primary drug of abuse in the work place is alcohol, this means we should, for example, consider or legalize the others. That is not what I mean at all.

Mr. RANGEL. Nobody got that impression on this side of the table.

Mr. Coughlin.

Mr. COUGHLIN. Could I yield briefly to Mr. Shaw on the question? Mr. SHAW. I would like to drive home a point. I am tired of people making this analogy. The reason alcohol is the primary abused drug is because it is legal. That is why.

Mr. MILLER. There is an interesting point, however, Congressman, and that is alcohol use, hard alcohol, liquor, is on the wane, and it is on the wane not because people are criminalized who use it, we didn't even criminalize users in prohibition in the 1920s, it is on the wane because American people respond to education and not coercion, and they are beginning to learn that it is not good for you. People don't eat red meat as much as they used to or fried food as much as they used to; tobacco use is down. The tobacco industry is going abroad to make its market bigger. Why? Education, not the coercion of jail cells.

Mr. COUGHLIN. Let me reclaim my time.

Mr. KAREL. There are other ways of trying to also influence behavior in addition to education and prohibition. That is the reason this comes up. You are tired of hearing that, I get tired of people saying even though there was Al Capone in the street, the rate of cirrhosis was down. I say, yes, but look what was going on in Great Britain at the time where the rate of cirrhosis declined, matched ours and instead of making our mistake, when we repealed the Volstead Act, when all of a sudden we had advertising and Spuds McKenzie and so forth, they were able to keep their rate down. I think everyone shares the goal that we want to see less abuse. We don't want to see problems in the work place.

The question is: Is this what we are accomplishing? I sometimes get a feeling people are talking as if what they are doing is making things better through current policies, and I don't believe that. I am not sure that the legality of alcohol per se is why we have the worst problem, but I have strong feelings that advertising Spuds McKenzie, you turn on the national football league, and what do you see?-does encourage alcohol abuse. Budweiser commercials. That is so accepted. Do you question that? I don't most of the time. Recently I have, and I said, gosh, why am I watching this beer ad on television when alcohol causes 125,000 deaths a year. I agree with Professor Masi, that our current alcohol policy is not an argument for modeling regulations of other drugs on it, but what it shows is maybe we are not looking at things clearly. There is not a lot of clarity. That is all.

Mr. RANGEL. Mr. Coughlin.

Mr. COUGHLIN. As far as you know is there any way of estimating how many additional addicts we would have if we legalized these substances, in view of the fact that they would be more plentiful and less costly?

Mr. MILLER. There is some information that indicates the availability of marijuana in the relaxed era of the 1970s-someone said yesterday overall marijuana use was up. It was up, but not in the areas where availability was relaxed. There is also some indication from the Dutch model that people would rather go to a legal drug like marijuana, which is available over there, than to some of the harder drugs and that it sort of stops people from going that little step further.

There is a need for more data, and I am not saying it is conclusive. The indications are, however, that the availability of that one drug, marijuana, does not increase use. There is indication that it does not lead people to go to harder drugs if they are not made available, legally that is. And I think that one of the reasons why,

and I hope this is one of the perceptions that Chairman Rangel had in saying that he needed more hearings, is that we need to examine issues like that. We haven't been examining them. The NIDA report was in 1980 or 1981, they have issued nothing since then. Mr. COUGHLIN. Is there any way of estimating how many additional injuries would result due to automobile and railroad accidents if we legalize these substances?

Mr. KAREL. I was talking to Peter Reuter, senior economist for the Rand Corporation-his name may be familiar to some of you on the panel. We were talking about the upcoming debates and so forth. He mentioned to me one very important statistic, involving the use of marijuana by the high school age group, and he pointed out 88 percent of the kids said they could get marijuana. In Mr. Reuter's opinion, and incidentally he hasn't come out one way or another on legalization, he does not believe, at least as far as the economics go, legalization would make a great deal of difference in terms of availability.

I am not suggesting, Mr. Mitchell isn't, that we do put marijuana or cocaine on the supermarket shelves. I think most people recognize there are significant risks there. I looked at one study done based on an alcohol abuse model in terms of the development of marijuana dependence, and it showed beteeen five and nine percent, even with marijuana, do develop some degree of psychological dependence, whether or not you call it addiction is not important. Based on a population now of approximately 20 million marijuana users, you can extrapolate what five percent of that would be.

Mr. COUGHLIN. Are you taking the position there would be no increase in accidents if you legalized-

Mr. KAREL. I am not sure that many more people would be using marijuana in a harmful way. I will say one thing. I think whatever is done in any degree needs to be followed carefully in terms of longitudinal research. It simply isn't true once you do something there is no turning back. Things need to be done carefully, slowly, they need to be monitored. You want to exercise damage control.

I really sincerely believe, and I know how wrong Representative Rangel thinks I am and other are, that the people I have spoken to who are on my side of the issue feel that we are trying to make things better. I know you all don't agree with that.

Dr. MASI. I think what we have to look at is the primary drugs of abuse today are the legal drugs: alcohol, tobacco and prescription drugs which we haven't addressed too much today..

Mr. COUGHLIN. The question I am asking is if you legalize these substances, would there be an increase in addiction and accidents resulting from drug use?

Dr. MASI. I think we heard from our first speaker this morning who talked about the experience in England and what happened there, and I think also the fact that the tremendous numbers of people using the legal drugs will tell us if we legalize more drugs, we certainly are going to have more abusers. It follows logically. One of the reasons there is less use of marijuana by the teenagers today, the NIDA survey also showed, there is some concern about the fact that there are restrictions and the fact that there are laws about it.