A forum for Congress to explore national remedies to substance addiction has attracted the converted — in droves. Its tasks now include educating the rest of Congress to address the problem — and to find affordable solutions on the national level. Founded in March, the caucus steadily grew to 45 members by the end of June.

Since its title is somewhat long, the group has become known unofficially as the Ramstad Caucus. Co-chair Kennedy “would prefer it go by its official name,” muses Kennedy spokesperson Ernesto Anguilla. Despite its bipartisan nature, Democrats comprise 32 of the 45 members. Hope could not explain the discrepancy except to suggest that constituents in Democratic districts may have pushed their representatives harder to join. “We sent an invitation to every congressional office,” she said.

No similar group exists in the Senate, but Senate culture allows for fewer caucuses.

Personal connections to issues of addiction
The founders and their most eager colleagues know about addiction issues firsthand — though all from different perspectives. Co-founder Ramstad is a recovering alcoholic with a history of addressing alcoholism issues legislatively. NAADAC, The Association for Addiction Professionals, and the National Mental Health Association have both named him Legislator of the Year. He also recently founded a Congressional Caucus on Fetal Alcohol Spectrum Disorders.

Kennedy, meanwhile, knows of drug problems because of well-publicized incidents in his family. His cousin David Kennedy died of an overdose. Kennedy has fought in Congress (so far unsuccessfully) for mental health parity and has sponsored legislation to educate health professionals on substance abuse and addiction. Caucus member Chris Van Hollen (D-MD) addressed the issue when he chaired a Health and Human Services subcommittee in the Maryland legislature.

Rep. Brian Baird (D-WA) practiced psychology 23 years, including addiction counseling. (Baird and Kennedy recently sponsored an amendment, adopted by the House, to the 2005 defense authorization act requiring a review of mental health and counseling services to military families.) Rep. Rob Portman (R-OH) started the Coalition for Drug-Free Greater Cincinnati. Earlier this year, Baird and Portman supported legislation to provide federal funds to fight methamphetamine abuse through law enforcement, education, and cleaning up contamination.

“Fighting an uphill struggle”
The caucus now will try to convince the rest of Congress to understand the issues, even though most probably will not join. The co-chairs “have been fighting an uphill struggle trying to get the rest of their colleagues just to know how damaging these disorders are both on the individual level and on the larger societal level,” Kennedy policy advisor Michael Zamore explained.

But at least one member who suffered from alcohol addiction has not joined. Rep. Phil Crane (R-IL) entered treatment four years ago. His chief of staff says no one asked him to join. “I don’t think he’s opposed to it but I don’t think he has thought of it one way or the other,” says Tami Stough, Crane’s communications director.

Response within the field
Still, the idea has caught on within the addiction treatment field. Join Together, a national non-profit that aims to help communities deal with substance abuse, put a notice on its Web site in early March asking supporters to urge their representatives to join. The notice generated at least 1,400 letters to members of Congress. “As far as we can tell, people from all over the country wrote to 330 different members...asking them to join. And that’s just the ones we know about” because they responded to Join Together’s request to carbon copy it, noted Join Together Director David Rosenbloom. The figure does not include phone calls or letters generated by Web site viewers who asked their friends to write, notes Eric Helmuth, Join Together’s director of Internet services.

“It’s not a huge number by Capitol Hill standards but it still got on the radar screen. Ramstad does feel some members joined because of grassroots interest,” Helmuth said.
The caucus first met in April, when it heard John Walters, director of the White House Office of National Drug Control Policy, talk about the new Access to Recovery voucher program for drug treatment.¹ A representative from George Washington University’s Ensuring Solutions to Alcohol Problems program discussed its Alcohol Cost Calculator that businesses and communities can use to determine the extent of alcohol problems (www.alcoholcost
calculator.org).

Meanwhile, “many members introduced legislation and asked us to let other members know about it. [The caucus] is becoming a platform to educate people about addiction, treatment and solutions,” Hope said.
The main lesson concerns the cost-effectiveness of treatment. The main legislative issue in the short term will probably involve parity legislation. “It is probably a two-step process of enacting mental health parity first. From there, it should be a natural extension to include chemical dependency parity,” Hope said, adding “we’re planning to look at the whole range of ways we can help on the macro and micro level.”

Ramstad and Sen. Norm Coleman (R-MN) introduced the Help Expand Access to Recovery and Treatment (HEART) Act of 2003 more than a year ago to require substance abuse parity but neither version has moved, despite 53 House cosponsors.

How the caucus functions
The caucus does not have its own staff or office and staffers assigned to it also share other responsibilities. “When it’s fully matured and functioning, it may become an information clearinghouse,” Zamore said. Congressional employees might turn there for information (or even to get help for themselves or acquaintances). A caucus formed several years ago on methamphetamines offered staff training, including trips to labs with Drug Enforcement Administration personnel to see how the drugs are made, Baird noted.

The caucus also provides a forum for members interested in addiction issues who do not serve on the relevant authorization or appropriations committees, Baird added. “Caucuses allow us to come together for informational purposes and amplify the voice....If there’s a proposal for a new treatment initiative or new funding or to eliminate an ineffective program...we may sign a letter of support or opposition to the committee.”

Van Hollen said, “I think it’s a very important priority for Congress and at the local and state level and it should be at the national level too. We need to do a better job of prompting awareness of addiction issues and we need to do a much better job of expanding access to treatment.

“It will mean we’ll band together as a group to try to increase funds available to states and localities for both prevention and treatment...but also to raise awareness about the issue generally (by keeping Congress informed)....There’ll be additional meetings going forward to plot strategy.”

Congress pushing additional issues
One issue some members of Congress hope to push in the immediate future consists of providing comprehensive services to recently released prisoners. The holistic approach would include addiction treatment, job training, and housing services, among others. A bipartisan group of representatives on June 23 introduced the Second Chance Act of 2004 (H.R. 4676), designed to help ex-convicts when they return to the public. The legislation would provide $40 million in grants in each of the next two years to provide services including treatment for alcohol and drug abuse. Sponsors kept the funding small to be realistic in a tight budget time. Both the Judiciary and the Education and the Workforce committees will have to consider the bill.

“We have not tried to do everything. We tried to do what we think we could. We have tried to keep expenses low” because of the federal budget deficit, Portman explained.

The bill would also establish a Task Force on Federal Programs and Activities Relating to Reentry of Offenders, consisting of representatives from different federal, state, and local agencies. The task force would examine the effectiveness of programs, identify research needs and suggest ways agencies working with ex-offenders could work together. It would also highlight successful programs, so Congress could find out what works and what needs to be done instead of just throwing money at the problem. The task force would get a year to recommend improvements.

The original sponsors include caucus members and Republicans Portman and Mark Souder (IN). “Locking people up is a short-term solution, not a long-term solution,” explained Souder, a self-proclaimed conservative. “You are creating a bigger problem than you started with if you don’t have rehabilitation programs inside and outside of prisons.”

Rep. Danny Davis (D-IL) pointed out that the legislation addresses addiction as one of many issues and services might work better if the ex-prisoners get addiction treatment along with housing, employment and other assistance as part of a coordinated program. Sen. Sam Brownback (R-KS) planned to introduce similar legislation in the Senate. Though he had not seen the legislation when he spoke to Counselor, Van Hollen said “it doesn’t do us any good to send people to prison with addiction problems and let them out with the same problems.”
Sponsors estimated that more than 600,000 prisoners a year are released, most with addiction problems.

Though it did not specifically endorse the bill, the White House issued a statement saying that the bill “includes key elements of the president’s prisoner re-entry initiative [proposed in January]....We urge the House and Senate to work in a bipartisan way to get legislation passed this year that is consistent with what the president outlined.”

Three-year grants have been awarded to 14 states and one tribal organization: California, Connecticut, Florida, Idaho, Illinois, Louisiana, Missouri, New Jersey, New Mexico, Tennessee, Texas, Washington, Wisconsin, Wyoming, Californal Rural, Indian Health Board
In their applications, grantees delineated a process for screening and determining appropriate services for the individual client. Clients will be assessed, given a voucher for identified services, and provided with a list of appropriate service providers from which to choose.

Editor’s note: If you have any questions about the Addiction, Treatment and Recovery Caucus, call Karin Hope of Rep. Ramstad’s office (202-225-2871).

Charles Pekow, MSJ, has been a freelance Washington writer for more than 12 years. His work has appeared in the Washington Post and many other journals. He won the Washington Writing Prize from Washington Independent Writers in 2003 for best reported story.

Footnote
1On August 3, 2004, President Bush announced $100 million in Access to Recovery grants to provide people seeking drug and alcohol treatment with vouchers for a range of appropriate community-based services. By providing vouchers, the grant program promotes client choice, expands access to a broad array of clinical treatment and recovery support services, including services provided by faith- and community-based programs, and increases substance abuse treatment capacity.

This article is published in Counselor,The Magazine for Addiction Professionals, October 2004, v.5, n.5, pp. 30-32.

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