Moyers on Addiction: Close to Home; 105; The Politics of Addiction

THE POLITICS OF ADDICTION

RICHARD NIXON: America's public enemy number one in the United States is drug abuse. In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive.

Unidentified Police Officer #1: You got the right to remain silent.

GERALD FORD: The people who traffic in hard drugs are nothing less than merchants of death.

Unidentified Woman #1: (From vintage television commercial; singing) Wouldn't a cigarette taste good right now? Wouldn't you like a Marlboro? Get a world of flavor...

NANCY REAGAN: If someone offers you drugs, what will you do?

Unidentified Girl #1: No!

Unidentified Boy: No!

Unidentified Girl #2: No!

RONALD REAGAN: Just say no to drugs.

Unidentified Man #1: (From television commercial) You've got the remote control in one hand, a great tasting ...

ANNOUNCER #1: (Excerpt from public service announcement) This is your brain on drugs.

GEORGE BUSH SR: This is crack cocaine, seized a few days ago just across the street from the White House.

PENNY: (From Partnership for a Drug-Free America) Drugs are bad.

BILL CLINTON: I experimented with marijuana a time or two, and I didn't like it and didn't inhale and never tried it again.

BILL MOYERS: I'm Bill Moyers. We're constantly bombarded by conflicting messages about drugs in America. Some try to prohibit drug use; others, to promote it. Users of illegal drugs are the target of tough law enforcement. Consumers of alcohol and tobacco are the targets of expensive advertising. We try to discourage young people from using any addictive substance, while all around them adults are not only using but glamorizing products that can hook and kill you. No wonder public officials have long been frustrated by the challenge of developing effective policies toward addiction. Our attitudes teeter like a see-saw, up and down, back and forth, pushed and shoved by markets, morality and millions of personal choices. The result: drug policies that add up to another civil war, which no one wants to lose and no one knows how to win. In this final broadcast of our series, we report on the debate over our drug policies and the growing movement to change them: The Politics of Addiction.

There has been a revolt against the war on drugs where you might least expect it: in Arizona, the land where Barry Goldwater gave rise to the modem conservative movement. But Arizona shares a border with Mexico and is on the front lines of the drug war.

Unidentified Police Officer #2: Freeze! Police! We have a search warrant! Open the door!

Unidentified Police Officer #3: Police! Search warrant!

BILL MOYERS:Arizonans have looked at the price of that war and declared they don't like what they see.

RANDALL RICE: (Department of Probation) The citizens of Arizona said, 'What we've been doing isn't working.' And we might not have all the answers, but we--all we know is that the way we've been handling this problem, which is just getting bigger--I mean, 80 percent of our prisons are populated with substance abusers. Eighty percent of the thousands of people we have on probation need drug treatment. And yet the old protocol was you lock 'em up if they make a mistake. The community, I think, is finally getting smart enough and sharp enough to go, 'Well, wait a minute. I don't think that's working anymore, and they're saying to the legislators, 'We need something else.'

ANNOUNCER #2: (From television commercial) What are Arizonans saying about Prop 200? The Gazette's Bill Hart writes ...

BILL MOYERS:That something else was Proposition 200, passed in 1996 by a grass-roots movement that caught the politicians off guard with a hard-hitting advertising campaign.

ANNOUNCER #3: (From television commercial) Prop 200 will save money, free up space for violent offenders and let Arizona invest millions in prevention for our children now so we don't pay later.

DOROTHY: (Leads A Retirees' Group): (Paid for by Dr. John Sperling, Peter Lewis, George Soros, & the Drug Policy Foundation) Everybody knows we're losing the war on drugs. Prop 200 gives us a new way.

BILL MOYERS:Prop 200 OK'd medical use of marijuana and other drugs for sick people. It set up a parents commission to develop drug-prevention strategies for the state. It mandated that violent drug offenders serve 100 percent of their sentence, and it called on the state to rehabilitate non-violent drug offenders by requiring treatment instead of jail.

Unidentified Judge: This will do it then. Let's see you back here June 6th at 9:30. You're released from custody today. Good luck.

BILL MOYERS:Leading public officials opposed Prop 200.

State Senator JOHN KAITES: There are some very dangerous things in Proposition 200 as well: the release of 1,000 dangerous prisoners onto our streets, very dangerous; the fact that--that if you have somebody in custody, you must release them if they're a drug offender, and if they continue to use drugs and continue to violate the law, you must give 'em probation again.

BILL MOYERS: Critics also pointed out that the Prop 200 media campaign was partially financed by outsiders.

General BARRY McCAFFREY: (Office of National Drug Control Policy) To be honest, I see much of it was pushed by a national drug legalization agenda. That was not good medicine. That was cunning public-policy manipulation.

BILL MOYERS: But the majority of voters felt otherwise.

Unidentified Man #2: (Paid for by Dr. John Sperling, Peter Lewis, George Soros & The Drug Policy Foundation) So vote yes on Prop 200. It's a better way.

Unidentified Man #3: (Paid for by Dr. John Sperling, Peter Lewis, George Soros & The Drug Policy Foundation) It's a new and better way.

Unidentified Man #4: (Paid for by Dr. John Sperling, Peter Lewis, George Soros & The Drug Policy Foundation) It's a better way.

BILL MOYERS:...and approved Prop 200 by a 2:1 margin, creating a new debate on drug policy in this most conservative of states.

Former Governor FIFE SYMINGTON: I think, even though I disagreed with Prop 200, that it was a good thing in terms of stirring a tremendous public debate. It's enhanced public awareness, and we'll be fighting the issue right on through the '98 elections, and I think that debate is healthy.

BILL MOYERS:So the revolt is coming from the people who ...

Unidentified Man #5: From the right.

BILL MOYERS:These are all the people who made it happen, local citizens all.

LINDA RAWLES: (Grand Canyon University) I'm a Christian libertarian Republican, if I must put a label on myself.

BILL MOYERS:Libertarians, conservatives, liberals, Republicans, Democrats, independents, lawyers and clergy, businessmen and judges, scholars and doctors.

Dr. JEFFREY SINGER: (MD) I personally think that the war on drugs is--is about as logical as alcohol prohibition was. It's more destructive, however, because you got much more modem weaponry. I think it's the number-one cause of drug addiction in this country and number-one cause of violent crime, particularly inner-city crime.

BILL MOYERS:They put the initiative on the ballot. It was an unusual coalition brought together by varying motives.

Dr. ROSS LEVATTER: (MD) I see this fundamentally as a rights issue. I think people have as much right to ingest in their own body what they see fit without harming other people as they do to ingest ideas by reading books into their own minds without harming other people.

LINDA RAWLES: We have lost more civil liberties in this so-called war on drugs than we have lost in the 200 years of this country.

MEL HANNAH: (Urban League) The part that got our support was that you mean my youngster, or my daughter, who is now in prison, isn't a criminal if I can support a proposition like this? That was the educational part that made a big difference in the--in our minority community.

CHRISTOPHER JOHNS: (Public Defender) Drug use is pretty well spread through the society, but the enforcement of the drug laws has fallen on those parts of the community where Latinos and blacks are concentrated and they now make a disproportionate number of people in prison.

BILL MOYERS:Is there any other political issue that you know around which this many different people could have

rallied?

JOHN NORTON: (Goldwater Institute) I regard it as almost a miracle that out of this caldron of--this disparate group that were brought together and kind of coalesced to create this, that we were able to create a--an initiative that we all were able to back and we all believe in.

BILL MOYERS:A Carter Democrat and a Reagan Republican.

Unidentified Man #6: Yes.

JOHN NORTON: That's right.

Man #6: Right.

LINDA RAWLES: But the bottom line for all of us in this room, whether we be liberals, libertarians or conservatives, is that we would rather have that bed space be taken up by a rapist, a robber or a murderer than someone who has a--an abusive substance problem.

MARVIN COHEN: (Attorney) What is drug addiction? It's not a crime. It--it--it's a sickness, and you start from there and then you make decisions on the basis of that instead of starting with them being criminals.

BILL MOYERS:To understand why Arizonans were so frustrated with the current drug policy, just visit the county jail, the fifth largest in the nation. The state spends about $662 million a year on its prisons and jails, which are so crowded many inmates are housed in a tent city in the desert.

Of those 6,600 inmates in your jails, how many of them are connected to drugs?

JOE ARPAIO: I would say either addic--either drug use, sales or drug-related crimes, about 65 percent, 70 percent, which is average across our nation in prisons and jails across the nation.

BILL MOYERS:Sheriff Joe Arpaio has tried to make his jail the toughest in America. He's dressed the inmates in striped uniforms and put some to work in chain gangs.

JOE ARPAIO: I'm trying to do it for their benefit--make it so tough they hate the place; that they'll never use drugs again. And so that's what I'm trying to do. If we could wipe out the drug problem, we would wi--wipe out 60 percent, 70 percent of crime.

SASHA HENRY: This whole jail is mainly filled with people with drug problems. They steal for their drugs. They have sex for their drugs. It's all for the dope. It's for the drugs.

BILL MOYERS:Sasha Henry is 21 years old. She was arrested for stealing to support her habit.

SASHA HENRY: You'd use up all your money. You use up all your ends. I had credit cards. I max--excuse me--maxed 'em out. After that--after I maxed out the credit cards, it was time to go to something else, so I started shoplifting. After I started shoplifting, I started embezzling. I'd work at a job and start stealing out from the drawer. I got caught stealing $3,000--landed me here.

BILL MOYERS: Sasha was a promising journalism student at Arizona State University.

SASHA HENRY: Right.

BILL MOYERS:Did you--you never thought, 'I'm going to become an addict,' did you?

SASHA HENRY: No. I still--I still, for a long time, didn't think I was, until I landed here. I never admitted it. had--didn't really tell my family the whole gist of things. I didn't tell them I'm--I'm an addict. I kind of hid it 'cause I'm ashamed. My--I have a very educated family. I mean, everybody in the family's not just have a degree, they have a degree and a masters or a PhD or a law degree and--a doctorate, and here I am a drug addict. You know, it's just like the family black sheep.

BILL MOYERS:And your mother?

SASHA HENRY: She cries a lot on the phone. It's really hard. She cries a lot, and I don't--I try not to call home because she cries so much, you know, and it makes me cry that I've hurt her so badly. My dad's just real--doesn't talk about it. He doesn't want to hear me and hear almost on the verge of tears. You know, it's hard. I used to say, 'No, I'm not an addict.' Most--a lot of people out there are functioning addicts, and they just

need to realize that one day it's just going--boom--it's not going to be functioning anymore. You're going to wake up and not want to go to work and then you're going to come on a binge and you don't come out.

BILL MOYERS:Regina Brandt is 21. She was arrested for possession of crack cocaine.

REGINA BRANDT: The feeling that you get when you--when you take that hit, you forget about everything. You're just high. You're having fun, the--the lifestyle, the party, the good times--always a good time, till you run out of money. Then you got to figure out a way to come up with it. But it's always just a good time. You don't--you have no responsibilities. You're carefree. It's gr--it's--it's good.

BILL MOYERS:Did you ever violate the law to get money? Did you ...

REGINA BRANDT: Oh, yeah.

BILL MOYERS:Did you--you sold to get money ...

REGINA BRANDT: The whole ...

BILL MOYERS:...for your drugs?

REGINA BRANDT: Mm-hmm. The--everything I did was against the law. I stole. I did burglaries. I--I robbed people. I. ..

BILL MOYERS:Armed robbery?

REGINA BRANDT: Yeah. Uh-huh. I've done prostitution.

BILL MOYERS:The stuff really owned you, didn't it?

REGINA BRANDT: Yeah, it did. It did.

BILL MOYERS:And you never knew that when you began?

REGINA BRANDT: Huh-uh. I didn't think it was--I didn't think it was that powerful. I didn't think it was that powerful at all.

BILL MOYERS:Do you think this will help you cope with this addiction?

REGINA BRANDT: Uh-huh. I see it--I--I--it's opened my eyes completely.

BILL MOYERS:How?

REGINA BRANDT: Well, being away from my son's the main--my main priority in life is my son, and he--he started talking and he--he's--I missed out on his first words. I missed out on him just running and, you know, he--walking. He started walking without me. I missed out on everything, and I regret it. I regret it bigtime. If I didn't get locked up, I probably would have been dead by now.

BILL MOYERS:And your son would have been orphaned.

REGINA BRANDT: Right. I would have been dead by now. I know I would have. I would have.

BILL MOYERS:Do you think any good will come out of the experience here? That's the debate, whether people like you should be incarcerated or whether you should be mandated to treatment.

SASHA HENRY: It will be--I don't want to say this experience is going to do me good because I'm miserable here. Only reason it's going to do me good is it's brought me closer to my mother. But the only thing that's going to do me good is getting into some counseling, to some drug treatment program.

BILL MOYERS:Many of the people in this jail are here because they violated their probation by committing additional drug-related offenses.

Unidentified Prisoner #1:You're in here for three months or four months. That's--that's your sentence. Early release to rehab. Early release to rehab never happens, OK? By the time you get out, you're--you still haven't been to a rehabilitation program to deal with the drug issues that you have. Your time's up; you're out on the street.

What do you do? You go right back to old friends, old behavior, old places. OK. And then you're right back on the dope, and then you get violated again. You're right back in here for three or four months more. By the time your early release to rehab comes up, which never happens, of course, you're right back out on the street with four more months. Revolving door? I guess so it's a revolving door.

BILL MOYERS:How do we break this cycle between the people who come into your jails and go out and use and abuse and come back and go out and come back because they're addicted? How do we break it?

JOE ARPAIO: I don't know, Bill. I--I'm going to be honest with you. If I think I had the answer, I'd probably be making millions. Around the--the--I don't have that answer. But on the other hand, let's try to do things differently, and that's what I'm doing with the Alpha program, trying to rehabilitate and have prevention courses in their jail. I still feel that's the best way of doing it.

What do you waste anyway? They're in jail. We have to feed them. We have to clothe them. Why not treat them if we can?

BILL MOYERS:Even a hard-line drug warrior like Sheriff Arpaio has tried to provide some treatment to addicts in jail. It's a seven-week program called Alpha.

JUDY DUSELL: (Counselor) The big question is: What is your motivation to quit?

BILL MOYERS:Judy Dusell is the counselor.

JUDY DUSELL: One of the pluses I like about doing rehab treatment in the jail is that people don't expect to grow in this setting, and I think Alpha has shown that personal growth can happen while you're incarcerated.

You got to do something new with the pain.

PEDRO: 'Cause I lost my kids.

JUDY DUSELL: What else did you lose?

PEDRO: My life. My freedom.

JUDY DUSELL: Is that not enough to motivate your heart? You got to do something with it, Pedro. If you're motivated, get out of those chairs and stand up.

BILL MOYERS:It's a new pilot program available for only 14 women and 15 men at any given time.

Unidentified Prisoner #2: Fifteen at a time. You got thousands of inmates in here. Everybody's trying to get into this program because it's good.

BILL MOYERS:A lot of people were surprised that America's toughest sheriff would create a program for rehabilitation of drug addicts while they're in prison. That seems soft to some people.

JOE ARPAIO: I--I balance that out, Bill, with the pink underwear, green bologna, no coffee, no cigarettes, no movies, no television, except Newt Gingrich, The Weather Channel and Donald Duck. That's all they get to see.

NORMAN HELBER: I don't think, personally, a message of fear is the greatest motivator for change in the world, and it's pretty much the one we've adopted as our public policy.

BILL MOYERS:The man in the middle of moving Arizona from a drug war to a public health strategy is the head of probation, Norman Helber.

NORMAN HELBER: I saw originally Proposition 200 being our community kind of opening its arms to those that were addicted and those who were in the--in the--in the clutches of--of a substance and saying, 'Come into the fold. We're going to work with you.'

BILL MOYERS:Arizona is experimenting with different ways of dealing with drug offenders depending on the seriousness of their crime and their addiction.

Judge: Well, good morning again, ladies and gentlemen, and welcome to the drug court program. You have all been recently placed on probation.

BILL MOYERS:The state is expanding special drug courts that divert first-and second-time offenders into treatment programs.

JUDGE: Your admission during your counseling session of your relapse...

UNIDENTIFIED MAN #7: Mm-hmm.

JUDGE: ...shows some real responsibility. And that's what we're trying to build here. This will be a five-week contract.

UNIDENTIFIED WOMAN #2: Mm-hmm.

JUDGE: I'm going to order your release from custody as of today.

WOMAN #2: Mm-hmm.

BILL MOYERS: If an offender drops out of the program, it's back to jail.

RICK ROMLEY: (Attorney) There comes a point in time when you have to say, 'Enough is enough,' and the jail is used and it is imposed.

BILL MOYERS: Rick Romley is the Maricopa County attorney.

RICK ROMLEY:Anybody that thinks that an individual that is on drugs will voluntarily go into treatment is living in another world. These people, you know, they don't recognize that they have a problem. The idea of jail is critical for successful treatment. You've got to hold that over their head.

JUDGE: You're going to have to work on your community service, so for this five weeks you'll have to do 20 hours of community service and you'll have to be back in court on May 30th. -

NORMAN HELBER: Most of 'em want help. They want to stop, much like the cigarette smoker who wants to quit. It's not available for most of our people; the waiting lists are long. We even have our in-house drug treatment programs that we've started in probation, just because there was not sufficient treatment in the community and our own programs are backlogged.

COUNSELOR: Party atmosphere...

BILL MOYERS:These ex-prisoners are now out on probation and trying to go straight. Two nights a week for six months they attend a special treatment program. They are also routinely tested for drugs.

COUNSELOR: Freeze. Actors, what are you thinking?

KRISTIANSEN: Well, I think society has stereotyped a lot of people who get hooked on drugs and who become addicted that they're--the stereotype just really isn't true and they're not all losers.

RANDALL RICE: We're seeing 78 percent of our people make it through a nine-month: intensive, outpatient, mandated treatment program. They're not dropping out; they're not quitting; they're not saying, 'This is ridiculous.' They're staying in and they're learning.

COUNSELOR: OK, Jason, what's going on for you?

RANDALL RICE: We're finding offenders that are coming back to group and reporting that, 'I was gonna shoplift today, except that I remembered what we learned in class, and I put the stuff back.' And now they're getting really mad at my counselors and they're cursing at them. The point is they're not doing the behavior.

BILL MOYERS:Treating the thousands of addicts and alcoholics on probation is a massive undertaking.

COUNSELOR: Let's talk about the positives. What's the positives about treatment?

Unidentified Woman #3: The honesty .

RANDALL RICE: All of a sudden now we're in a real complex situation where we have to be the facilitators for treatment that is court-mandated by Prop 200, and yet we have no resources to do that. So that puts the burden on us to provide treatment like we're doing in CPP internal and train officers--train clin--clinical specialists like I have in my program, diversify who can provide the services because we're going to have thousands of people, literally, that need treatment all at once with not very many resources.

BILL MOYERS:Prop 200 earmarks $8.6 million a year from alcohol taxes to help the state convert to a public health approach.

Unidentified Woman #4: Donald Vocal.

DONALD VOCAL: Still, those eligible for help far outstrip the resources available.

Mr. BROWN: From the time I was a baby until I was 11, when I started doing heroin, I finally said, 'Well, you know what? This is--this is what I've been looking for.' And this is what I--I continued to do for many, many, many years. I quit school when I was in sixth grade and went to work and--to supply my habit. And then after I couldn't do that, I started robbing. I just started thieving.

BILL MOYERS:Hard-core addicts are especially difficult to help. They've been around drugs and crime for years.

Mr. BOTELHO: If you don't have the hope to begin with, then where does choice start? If you take a dog and kick him out on the street, is he not gonna try to eat? That's the same thing with a drug addict. If you put him on the street, he's got no hope. He's gonna steal; he's gonna do drugs. He's got no change of life. He sees no future. He's gonna keep going on.

Unidentified Woman #5: One, two, three.

BILL MOYERS:When they're released, they need long-term residential treatment, which is scarce. The competition to get in is intense and they must pass some tough screening.

Mr. BROWN: I'm fighting for my life here. What's your name?

EDWARD PINNOW: (Maverick House) Ed.

Mr. BROWN: I'm fighting for my life here. I'm not getting no younger. I am not going to spend the rest of my (censored) life in the joint. I'm not going to do that. I want the nice house with the little picket fence with a couple rugrats running around; take 'em to the ballpark and take 'em to the zoo. My life isn't at the end of a needle anymore. Man, I don't--man, I'm so burned out with this (censored).

RICK ROMLEY:Look it, you look at these individuals' records and you see the opportunities. They've been offered treatment over and over again. They've been offered treatment, get off the drugs, get off the drugs. And you know what? They go back out and they're burglarizing homes, they're stealing cars or whatever. And there comes a point in time when you have to protect the public, and enough is enough.

EDWARD PINNOW: It doesn't work for everybody, OK? There's an old joke: How many--how many counselors does it take to change a light bulb? Well, only one, but the light bulb has to want to change.

How much crack would you smoke a day?

Mr. BOTELHO: I'd say I got about a $400-a-day habit.

EDWARD PINNOW: And how long does that take you to smoke $400 worth of crack cocaine?

Mr. BOTELHO: Seven hours, eight hours.

EDWARD PINNOW: So they need to be willing to make the choice, the decision, 'I want to stop using. I don't know how to stop using. I need help.' Finally, 'Can you help me?'

Mr. BOTELHO: Now I got people trying to help me; I'm trying to get myself straight.

EDWARD PINNOW: So how are you going to respond when you're asked to talk in a group of people at Maverick House when you're going to need to expose some real personal issues, really become vulnerable with these people?

Mr. BOTELHO: I ain't going to say I'm not scared. I mean ...

EDWARD PINNOW: Well, when push comes to shove and you are scared to go into group therapy, are you going to break weak or are you going to stand up and be...

Mr. BOTELHO: No, I have to go. I mean, I know what I got to do, and I'm willing to do whatever I have to do.

EDWARD PINNOW: Well, the average wait right now, unfortunately, in Phoenix, to get into a residential treatment is about three to six months.

NORMAN HELBER: The resources aren't out there, and that's the issue; that there's unlimited resources for incarceration, there's unlimited resources for building more prisons or more jails. What we've got for the poor people going through the criminal justice system is a wait in jail for placement in a bed that never happens. You see, we've created a public policy that says the wealthy who have a drug problem can go to Betty Ford. The poor who have a drug problem can go to the Maricopa County Jail.

MARVIN COHEN: The public understands that there's a difference between crime and drugs. Arizona's public is like a microcosm of the United States. Most people in the country understand that the drug problem is not a criminal problem, but the politicians haven't caught up.

BILL MOYERS:Arizona's struggle to reform its drug policy isn't over. The state Legislature and the coalition have battled back and forth.

SAM VAGENAS: It's about our failing politicians and our failing drug policies.

BILL MOYERS:But this fiercely independent state has set out on a new course, and many are looking to learn from its example.

Dr. SINGER: In a way, this was sort of the crack in--in the dam, and--and we're going to s--see a whole lot of people speak out. They've been almost terrorized by our political class into--into silence on this. It's almost become you're afraid to say that you don't agree on drug policy because that means that you are pro drug, and none of us here are pro drug.

BILL MOYERS:The rumblings of reform have reached from the grass roots to Washington, where the drug war was first declared. The man in charge of drug policy is caught in the middle, between hardline drug warriors and advocates of change.

BARRY McCAFFREY:: We're spending $17 billion a year to lock up 1.6 million Americans. We're willing to pay $23,000 a head to keep them in a cell. We've got to develop the political will to spend the money needed not only on prevention programs but on effective drug treatment in the criminal justice system and during follow-on care.

BILL MOYERS:You've suggested abandoning the phrase 'war on drugs.' What's behind that?

BARRY McCAFFREY:: This metaphor 'war on drugs' has caused us some intellectual problems as we try and grapple with this issue. If it's a war, then how come we didn't win it? Who's the enemy? Where's the general to give us a top-down concept to lead us out of this morass? And eventually, do we achieve total victory? And I think the metaphor starts to break down. In some ways, it may be more useful to view it as a cancer affecting American society.

BILL MOYERS:A provocative metaphor, cancer. Think cancer; think cigarettes. That's not what we used to think. If we change the metaphor from fighting a war on drugs to treating an illness, it will take a cultural transformation as radical as how we changed our thinking about cigarettes.

MARLBORO WOMAN: (From vintage television commercial; singing) Have one with me. Have a Marlboro cigarette.

BILL MOYERS:It seems only yesterday that cigarettes were glamorous. Even doctors served as pitchmen in television commercials.

(Excerpt from vintage television commercial)

ANNOUNCER #4: So join Dr. Cary Middlecoff and discover the smoothest taste in smoking.

Dr. CARY MIDDLECOFF: It's the Viceroy taste.

MEN SINGING: Smoother, smoother.

(End of excerpt)

BILL MOYERS:Then the medical community started investigating the dangers of smoking, and in 1964 the surgeon general of the United States put the nation on notice.

SURGEON GENERAL: It is the judgment of the committee that cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.

MIKE PERTSCHUCK: Tobacco is as American as Chevrolet and apple pie.

BILL MOYERS:Mike Pertschuck was a young lawyer and an activist present at the release of the surgeon general's report. Over the next 30 years he became a leader in the campaign to make smoking a public health issue and to control the industry's power.

MIKE PERTSCHUCK: Cigarettes are the single most profitable consumer product. There's a wonderful quote from Warren Buffett, who was the--who was a great investor but a member of the board of R.J. Reynolds. His quote is, ìI tell you what I like about the cigarette business. It costs a penny to make; you sell it for $1; it's addictive.

Unidentified Man #8: (From April 14, 1994) You raise your right hand...

BILL MOYERS:But for years the tobacco industry presented a united front of deceit. ..

EDWARD HORRIGAN: (Chairman & CEO, The Liggett Group, Inc.) Liggett does not believe that there is any such thing as an addicting level of nicotine in cigarettes or that cigarettes are addictive like heroin or cocaine and has--as has been alleged.

BILL MOYERS:...and denial

WILLIAM CAMPBELL: (President and CEO, Philip Morris) People can and do quit smoking, according to the 1988 surgeon general's report. There are more than 40 million former smokers in the United States, and 90 percent of those who quit did so on their own without any outside help.

DAVID KESSLER: For every person who's successfully quit smoking, nine try and fail.

BILL MOYERS:Dr. David Kessler is the pediatrician who led the Food and Drug Administration's attempt to regulate tobacco as an addictive drug.

DAVID KESSLER: The companies would have you believe that smoking is a matter of adult choice. What choice do you have when you're dealing with an addictive substance, and what choice is there when you have 11-, 12-and 13-year-olds who are becoming addicted?

Unidentified Girl #3: (From public service announcement) I started smoking when I was 10 because I wanted to look older.

BILL MOYERS:Local initiatives against tobacco companies, combined with growing public outrage over the health cost of smoking, have brought about a remarkable change in public attitudes.

Unidentified Woman #6: (From public service announcement) I was a model in cigarette ads and I convinced many young people to smoke. I hope I can convince you not to.

BILL MOYERS:Few people could have imagined 30 years ago that the tobacco industry would one day try to negotiate an overall settlement with its critics.

Unidentified Speaker: (From June 20, 1997, tobacco settlement press conference) We are here today to announce what we think is the most historic public health achievement in history.

BILL MOYERS:Since 1964 smoking has decreased by nearly one-third. But recently smoking among teen-agers has begun to rise again.

BILL CLINTON:

(From September 17, 1997) Today I want to challenge Congress to build on this historic opportunity by passing sweeping tobacco legislation that has one goal in mind: the dramatic reduction of teen smoking.

BILL MOYERS:The tobacco wars are still being waged, but the fact is Americans now accept that smoking is addictive. It can't be prohibited, but it can be contained.

MIKE PERTSCHUCK: Those who look at the public health implications and the addiction implications of smoking would like to see it move to a--to a regulated regime in which those who are already addicted would have ready access to it--there would be no black market--but the companies would be restrained from the promotion and the glamorizing and the marketing and making it easy for kids to get.

BILL MOYERS:Physicians played a key role in the campaign to make smoking a public health concern. And now some of the same doctors are advocating a new public health policy for addiction.

Senator BILL FRIST: (Republican, Tennessee): Yes, I know all about you. Nice to see you. Yes, indeed. Welcome. Welcome.

BILL MOYERS:A group of noted physicians represents the first major effort of the medical community to push for drug policy reform.

Dr. JUNE OSBORN: (MD; Chair, Physician Leadership Group) Well, the group that we're representing is--we're calling Physician Leadership on National Drug Policy.

BILL MOYERS: They're calling for a fundamental shift of resources toward treatment and prevention.

Dr. LONNIE BRISTOW: (MD; Former President, American Medical Association) We've been able to uncover in recent years evidence that suggests that in terms of cost effectiveness, you can get much more for the tax dollars that are being spent if we concentrate on treating this as a chronic illness, which, in fact, is what it is. There are some interesting parallels between tobacco and the issue of illicit drug abuse because tobacco is a legal drug. No one thinks it's strange that a person might attempt to get off cigarettes and, six months later, fail and find themselves smoking again.

No one would say, 'Well, sorry. You've had your chance. You can't try to quit again.' But we tum to the person who's addicted to illicit substances and there's--and--and there's a tendency to say, 'Well, you're limited in the number of times in which you can try to quit because if you haven't succeeded after the first or second time, well, there's something the matter with you. You just don't have the will to--to do this.' We've got to bring that same understanding of the human condition that we do--that we have for legal substances to the abuser of illicit substances. -

Dr. DAVID LEWIS: (MD; Center for Alcohol & Addiction Studies, Brown University) And this distinction between legal and illegal haunts us. It's a century-long distinction that haunts us, and it doesn't always make medical sense at all.

BILL MOYERS: What about the knock on treatment? There's just a--a widespread consensus that treatment doesn't really work.

LONNIE BRISTOW: Treatment does work. Believe me, treatment does work.

DAVID LEWIS: We have more effective treatments, generally speaking, for addiction than we do for many of the other chronic illnesses, including many forms of cancer.

LONNIE BRISTOW: But what we've got to do is make it more readily available so the people don't have to jump hoops in order to get to an active treatment program.

JUNE OSBORN:The thing that got me first horrified as a physician about the substance abuse issue back in the mid-'80s was to discover that even if somebody who was addicted and who ha--and had gotten into the trap decided--did the hard work of deciding, 'OK, I want to get out of here. I w--this is dangerous. I don't want it. I don't want to get anywhere near HIV. I want out,' had to go on waiting lists.

DAVID LEWIS: You don't have a constituency of heroin addicts calling for more heroin addiction treatment. You don't have a constituency of cocaine addicts, because they're vilified in our society.

BILL MOYERS:Nobody wants to give them this chance.

DAVID LEWIS: No.

BILL MOYERS:As with their fight against tobacco, the doctors are being reinforced by citizens who know firsthand what addiction is like. Many recovering addicts and alcoholics have become professionals in the field.

PAUL SAMUELS: (Legal Action Center) I think the only way we can overcome it is to organize people who know better and to get them to speak out. There are millions of them around the country, millions of people in recovery or family members or--have had experience personally or indirectly with addiction who know about the disease. All we need to do is to organize them and get them to speak out, and that could change the entire public debate and the way addiction is viewed in this country forever.

WILLIAM COPE MOYERS:How ya doing?

BILL MOYERS: Good.

Among the activists for drug reform is my own son, William Cope Moyers, now the director of public policy at Hazelden, one of the oldest treatment centers in the country.

WILLIAM COPE MOYERS: I'm a recovering alcoholic and an addict. My wife is a recovering alcoholic and an addict. That makes my three children very susceptible to this disease. And where I try and bring in a recovering community is to say to them, 'I want my children to have the same shot to recover that I had and that my wife had.' And I think if we bring it down to that level, I think we can start to br--energize some of the recovering community to stand up and speak out.

BILL MOYERS: These leaders and activists in the addiction field have come to Washington for a strategy session, hoping to ignite a recovery movement.

What are the obstacles to developing a--a reasonable, rational health policy in this country?

SIS WENGER: (National Association for Children of Alcoholics) I think it's a stigma and ignorance, and one feeds the other.

JOHNNY ALLEM: (Mental Health Services) We will buy the idea that we're less than. We buy the idea that we aren't, quote, "normal."

ELIZABETH COLE: (Johnson Institute Foundation) If people with cancer stay anonymous, they're not going to get the support. If gay and lesbians didn't come out of the closet, they wouldn't get support. I think what--we need, in a sense, to come out of the closet.

R. JEFFREY JAY: (The McGovern Family Foundation) I'm an alcoholic and drug addict, and this is what one looks like. We love to have this vision of alcoholics--alcoholics and drug addicts as being those people. You know, they're on the other side of the track or they're a different race or they're a something. Really, it's everybody, and--and we've got to stand up and start talking about that on a national level.

WAYNE WIRTA: (National Council on Alcoholism and Drug Dependence) The central message has to be that this is a disease and it's a treatable disease and our advocating for adequate treatment. And--and I feel very strongly about that, particularly with kids, because I know if my younger daughter, when she was 14, hadn't had a father who worked in the field, she would not be in recovery today. And we're throwing away a whole generation of drug-and alcohol-addicted kids because we're not offering the kinds and the amount of services that are needed.

BILL MOYERS:So you think the time has come for a movement of recovering people who become constituents and advocates?

SIS WENGER: Yes. I think it is time. There--there seems to be this sense in the country that it's time to tell the truth.

PAUL SAMUELS:This may actually be an issue where the public, in many ways, is ahead of the policymakers. We see polls now where people in the general public get it. They understand that we should have much more treatment. They understand that addiction is a disease that can be prevented and treated. There are large percentages of people who will say we--even put more money into dealing with treatment and prevention; that we ought to be providing treatment rather than locking up people who have a drug problem. I think that there is a lot of understanding in the public, but that message is not being put together in any organized way, and--and it's often not getting to the policymakers.

JIM RAMSTAD: (Republican, Minnesota) Well, I'm a grateful recovering alcoholic. I've been sober now almost 16 years. I abused alcohol for 12 years. I was a weekend drinker, a binge drinker. I would drink to blackout proportions toward the end of my alcohol abuse days. And only because of a--an arrest when I landed in jail in Sioux Falls, South Dakota, on July 31st, 1981--that was my intervention. That's what got me to treatment and to--and to recovery, I'm grateful to say. I admire your courage coming--you know, coming out like that. I didn't have that luxury. I was--when I was arrested and sent off to jail, I was on the front page of the newspapers.

BILL MOYERS:Congressman Jim Ramstad, a Republican from Minnesota, wants to create a commission to formulate a national strategy on alcoholism.

JIM RAMSTAD: In the last election the liquor lobby spent more--twice as much in campaign contributions toward members of Congress than the tobacco industry. And everyone talks about the influence of tobacco, which is not insignificant, but I think we have to recognize that we're up against a pretty strong lobby in this country when we try to deal with this problem of alcoholism. And they might not do it openly, but believe me, behind closed doors they're twisting arms right now in trying to kill this alcoholism commission.

BILL MOYERS:Earlier this century Congress so fiercely opposed alcohol it was outlawed. Prohibition lasted 14 years, and although it reduced consumption, it also fueled political corruption and the birth of organized crime. Today the industry is a powerful presence in Washington, defending itself against higher taxes and regulation. Campaign contributions buy a receptive audience: a Congress under the influence of industries whose celebrated drugs take a higher toll than all illegal drugs combined.

JIM RAMSTAD: Too many of them don't get it. They don't understand the disease of alcoholism and addiction. They don't--they might pay lip service to the disease concept, but they really don't understand it. There's a much higher level of understanding in the Minnesota Legislature, where I served for 10 years, than there is here in Congress. So we have a massive education job to do on the part of members of Congress.

Sen. PAUL WELLSTONE: (Minnesota) Hey, Congressman, how ya doing? Congressman Ramstad! Much of this is an illness, much of it is diagnosable and much of it is treatable, all of which makes it tragic that we aren't really providing the care that people need.

JIM RAMSTAD: First of all, I want to thank you, Paul, because working in a bipartisan, pragmatic way on this is the correct approach.

BILL MOYERS:Paul Wellstone represents Minnesota in the US Senate. Because their home state has pioneered in the treatment movement, he and Ramstad want the country to follow Minnesota's lead. They have introduced legislation that would set national standards which insurance companies would have to meet in treating addiction as a disease.

PAUL WELLSTONE: Because it won't be just this bill. I think hopefully--what I'm hoping for, Jim, is that it will be good education for people in the country and we can--and we can sort of punch through some of the prejudice.

JIM RAMSTAD: Absolutely.

PAUL WELLSTONE: That--that's as important as anything.

JIM RAMSTAD: And--and if ever--if ever we were to galvanize, mobilize the recovering community of America, this is the time and this is the bill.

WILLIAM COPE MOYERS:And, Jim, it's going to people like you and people like me and Sharon and--and those of us who've been through it personally that are going to really have to sort of take the lead on that piece of it 'cause it's going to be hard.

PAUL WELLSTONE: Should we go on over? I think we should just walk over.

BILL MOYERS:Now this is a question I've never even asked you even though we've been through all this together, and it's: Why did you decide to go public?

WILLIAM COPE MOYERS:No comment. No--well, because if people like me don't stand up and speak out, no one else will either. I also, I hope, can be an inspiration for those who either are fearful or misunderstand what it means to stand up and speak out. This question of anonymity in some 12-step programs, the stigma--somebody has to take the lead. I'm just one of hopefully many who can do that.

PAUL WELLSTONE: I'm fired up! As a national community, we are now taking the position that there can't be discrimination against people. If you're going to cover people for physical illnesses and you're going to cover people for mental illnesses, you should cover people who are struggling with this illness of--of addiction. I mean, that's appropriate. And the federal government has to do it because if you don't have the national standard, a lot of these plans can't even be covered by the states.

BILL MOYERS:Each year alcohol, tobacco and illicit drugs cost billions of dollars in lost productivity, medical claims and accidents. Insurance companies say it would not only be too expensive to cover the cost of treating employees but that treatment has a spotty record and has often been abused.

JIM RAMSTAD: Half of the treatment centers have closed in the last five years. In fact, even more alarming: 60 percent of the adolescent treatment centers have closed in the last seven years in this country because the insurance companies have cut back in terms of providing coverage.

SHARON GLESS: I've never come forward in public and done this. I've been in recovery for almost 10 years, and I'm very honored that I was asked to speak.

BILL MOYERS: Sharon Gless co-starred in the popular TV series "Cagney & Lacey."

SHARON GLESS: But I'm here to tell you that treatment works. I was also one of the lucky ones that I was able to pay for my own treatment. Most people cannot afford treatment, no matter how desperate they are. Even those with private insurance coverage often discover that when it comes to treatment for alcoholism or drug addiction, what they need is not what they get. Quite simply, this is unfair. Only blocks from Capitol Hill is another Washington. Here, the toll from alcohol, tobacco and drug addiction is devastating.

ALPHA BROWN: I have aunts and uncles and cousins who've died from this. You know, I have my Uncle Percy, my cousin Percy, my--my Uncle Johnny, my cousin Johnny, my Uncle Jessie, my cousin Jessie, my Aunt Alice. I've--I've had my Uncle Dwight--all of these folks have died from alcohol and alcohol-related problems.

I need your help in helping me reach out to more--more youth.

BILL MOYERS:Dr. Alpha Brown is a pastor and community leader who is himself a recovering addict.

ALPHA BROWN: I eventually became captive of--of, first, alcohol and tobacco and--and then went on to other substances, the--the cocaine, the heroin, the--the acid.

BILL MOYERS:He lives and works in what he calls a culture of addiction. It's a culture he wants to change.

ALPHA BROWN: In our society there are subtle messages to consume alcohol in ways that are abusive, from the beginning. You can buy a 40-ounce bottle of malt liquor cheaper than you can buy a 32-ounce bottle of filtered water, and those kinds of things make abuse easy. Another alcohol outlet, another liquor store, another alcohol outlet, up and down the community.

BILL MOYERS:The District of Columbia has one of the highest rates of alcohol consumption, liquor availability and alcohol-related deaths in the country.

ALPHA BROWN: We want to see the number of alcohol outlets reduced. We would like to have all alcohol and tobacco signage removed from the inside and outside of stores wherever children walk or play. The illegal drug trade needs to be stopped, and the legal drug trade needs to be mediated. It needs to be brought under control. We cannot allow chemical substances to be viable substitutes for recreation, to be viable substitutes for spiritual growth and development. We can't let the spirit, the distilled spirit, the brewed spirit or the fermented spirit to replace the natural innate spirit of--of humanity.

BILL MOYERS:Drugs and violence are a lethal combination. Funerals for the victims are now routine. Meanwhile, the drug war has helped put almost half of Washington's young black men in the criminal justice system.

ALPHA BROWN: And he sent us into the world to proclaim liberty to those captive to any drugs, alcohol, violence or--or any lost waifs. The question this morning is not where was God, but it is where were we when Youssef needed us, and where are we when so many of our young males need us out here in the world today?

BILL MOYERS:Alcohol, tobacco and drug addiction cut across race and class. But in poor communities, major social forces and scarce resources make the chances for recovery much more limited and the damage much greater.

ALPHA BROWN: This body we commit to the ground, earth to earth, ashes to ashes, dust to dust. When the will is chained--and that's--that's essentially a definition for addiction, when your will is chained--when the whole society is promoting, when the government legitimizes the use of alcohol, tobacco and other substances, it's very difficult to find the strength, to--to find the safe space to recover it. Those of us who recover, sometimes I think that we work against the odds. I'd like to spend the rest of my life changing the odds, because our society should be a place where recovery is something that happens for anybody who wants it.

Unidentified Police Officer #4: Here he is. Here's another one.

BILL MOYERS:The war on drugs hardly makes for a culture of recovery.

Unidentified Police Officer #5: Get on the ground! Police! Search warrant! On the ground!

BILL MOYERS:For a generation we have employed force and violence, hoping to reduce the supply of drugs, drive up prices and punish users.

Officer #5: Get your legs out.

BILL MOYERS:But report after report shows drugs are as cheap and plentiful as ever and the number of heavy users undiminished.

The drug war has become the Vietnam of our time. We keep doing the same thing, expecting different results. This war costs the federal government $16 billion a year, about 2/3rds of it in a futile effort to keep drugs out of the country and off the streets.

Unidentified Woman #7: Hold real still.

BILL MOYERS:Despite everything we're learning about addiction, the government only spends about a third of its drug-war budget on treatment, research and prevention. Scientists tell us addiction is a chronic, relapsing disease that can be treated, not simply a matter of morality or a lack of willpower.

Unidentified Scientist: Nice-looking brain. Unidentified Addict: In my heart, I know it's over, but I keep--that's what I'm saying.

BILL MOYERS:We've learned it takes different treatments for different people. One size doesn't fit all. Studies show rehabilitation can be more effective and less expensive than jail. But our drug policies remain divorced from reality. We tell children, 'Just say no,' to some drugs, while our culture glamorizes the use of others. More Americans are hooked on alcohol and cigarettes than illegal drugs, but politicians don't call for force or punishment to curb smoking and drinking.

Unidentified Man #9: My morning's distracted ...

Unidentified Police Officer #6: You be quiet. Shut up!

BILL MOYERS:If drug addicts are poor and black, odds are they'll get locked up; if white and well off, they're more

likely to escape the criminal consequences that can mark a person for life.

BILL CLINTON: We continue our efforts to cut the flow of drugs into America.

BILL MOYERS: Our policymakers are like addicts in denial, unable to admit their strategy has failed and needs to be changed. We've become prisoners of the stereotypes, the stigma, the rhetoric and fear. It will not be easy to create a public health policy that is realistic and humane. Our best hope for change is from the ground up, listening to people who have come home from the war.

HOWARD JOSEPHER: (F.A.C.T.) When we were using drugs and we were trying to get our dope, if there was a mountain between you and your dope, you found a way to get around, under, over or remove the mountain. And people have always said if you can take the energy that a drug addict puts into getting their drugs and put it into something positive, something creative, then those drug addicts could change the world. And the key player, the one who brings heart, the one who brings spirit to this work are the people who've been there themselves.

Man #1: I see a problem where they need to be educated about this, a lot of the legislators. We can show something different.

HOWARD JOSEPHER: How do you feel about the idea of going into somebody's office or getting up in front. ..

Man #1: I have no problem with that.

HOWARD JOSEPHER: No problem?

Man #1: No problem whatsoever.

HOWARD JOSEPHER: OK.

Man #1: No, no problem with that.

HOWARD JOSEPHER: You don't need no training for that?

Man #1: I don't need no anonymity.

HOWARD JOSEPHER: A-ha!

Man #1: You know, I--I have no problem with that.

HOWARD JOSEPHER: OK.

Man #1: You know what I'm saying? I think we should do that.

HOWARD JOSEPHER: Right.

Man #2: I think everybody should.

HOWARD JOSEPHER: Do you have any concerns about speaking to elected officials? Unidentified

Man #2: No, I don't have any concerns. I just think that--like, the normal person that--you know, you think about the normal things, the repercussions ...

HOWARD JOSEPHER: Like what?

Man #2: ...family, friends.

HOWARD JOSEPHER: What do you mean, repercussions?

Man #2: Employment, for instance. You know, what are the possibilities of your employment being discontinued if your employer finds out that you're standing up to acknowledge that you were a substance abuser, you have your sobriety now? And, you know, how are they going to look at you? The possible situation with your family; if they feel that their family name has been tainted or something like that. Even your peers. You know, you wonder what might go on, but you still have to stand up and, you know, take it because we took the chance to use the drugs, so now it's to take a chance to keep society and things a little bit better, because we're the only ones that can really do it that way.

HOWARD JOSEPHER: Yes?

Unidentified Woman: I work at a needle exchange. I go one day a week, every week, and I've been working there since last month, November, because I'm in--I'm a person--I'm in recovery, and they still say, you know, 'Well, how do you do it? How did you do it? How are you doing it?' you know? And I've seen them. I've seen quite a few of them come in and say, 'Can you get me into a detox?' And when they say something like that, I really--I break--you know, like my heart just opens up.

Unidentified Man #3: I'm very, very passionate about my recovery, and like I said, I'm coming up on six years, and I help other people recover.

HOWARD JOSEPHER: Yes.

Man #3:You know, I do volunteer work in programs.

HOWARD JOSEPHER: Yes.

Man #3: I go and I speak and I help other people recover.

Unidentified Man #4: Hit the parks. Hit the church. Hit--hit barrios that--that is--is, like, drug-infested. We got to go out there. People are looking at me today and they're saying, 'Well, man, I remember that guy. Look at him today. He's a man.' I'm coming to three years clean, and this is what I got to tell my community. Let 'em know, man!